PURPOSE: The aim of this study was to evaluate the value of conventional 
factors, the Risk Assessment and Predictor Tool (RAPT) and performance-based 
functional tests as predictors of delayed recovery after total hip arthroplasty 
(THA).
METHOD: A prospective cohort study in a regional hospital in the Netherlands 
with 315 patients was attending for THA in 2012. The dependent variable recovery 
of function was assessed with the Modified Iowa Levels of Assistance scale. 
Delayed recovery was defined as taking more than 3 days to walk independently. 
Independent variables were age, sex, BMI, Charnley score, RAPT score and scores 
for four performance-based tests [2-minute walk test, timed up and go test 
(TUG), 10-meter walking test (10 mW) and hand grip strength].
RESULTS: Regression analysis with all variables identified older age (>70 
years), Charnley score C, slow walking speed (10 mW >10.0 s) and poor functional 
mobility (TUG >10.5 s) as the best predictors of delayed recovery of function. 
This model (AUC 0.85, 95% CI 0.79-0.91) performed better than a model with 
conventional factors and RAPT scores, and significantly better (p = 0.04) than a 
model with only conventional factors (AUC 0.81, 95% CI 0.74-0.87).
CONCLUSIONS: The combination of performance-based tests and conventional factors 
predicted inpatient functional recovery after THA.
IMPLICATIONS FOR REHABILITATION: Two simple functional performance-based tests 
have a significant added value to a more conventional screening with age and 
comorbidities to predict recovery of functioning immediately after total hip 
surgery. Patients over 70 years old, with comorbidities, with a TUG score >10.5 
s and a walking speed >1.0 m/s are at risk for delayed recovery of functioning. 
Those high risk patients need an accurate discharge plan and could benefit from 
targeted pre- and postoperative therapeutic exercise programs.