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<p>Abstract</p> <p>Background</p> <p>A fast-track intervention with a short preoperative optimization period and short postoperative hospitalization has a potential for reduced convalescence and thereby a reduced need for postoperative rehabilitation. The purpose of this study was to describe patient-related outcomes, the need for additional rehabilitation after a fast-track total hip arthroplasty (THA), and the association between generic and disease specific outcomes.</p> <p>Methods</p> <p>The study consisted of 196 consecutive patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one in-patient visit. The patients filled in 3 questionnaires to measure health-related quality-of-life (HRQOL) and hip specific function (EQ-5 D, SF36, and Harris Hip Score (HHS)) at 2 time points pre- and 2 time points postoperatively. The observed results were compared to normative population data for EQ-5 D, SF36, and HHS.</p> <p>Results</p> <p>3-months postoperatively patients had reached a HRQOL level of 0.84 (SD, 0.14), which was similar to the population norm (<it>P </it>= 0.33), whereas they exceeded the population norm at 12 months postoperatively (<it>P </it>< 0.01). For SF36, physical function (PF) was 67.8 (SD, 19.1) 3 months postoperatively, which was lower than the population norm (<it>P </it>< 0.01). PF was similar to population norm 12-months postoperatively (<it>P </it>= 0.35). For HHS, patients never reached the population norm within 12 months postoperatively. Generic and disease specific outcomes were strongly associated.</p> <p>Conclusions</p> <p>If HRQOL is considered the primary outcome after THA, the need for additional postoperative rehabilitation for all THA patients following a fast-track intervention is questionable. However, a pre- or early postoperative physical intervention seems relevant if the PF of the population norm should be reached at 3 months. If disease specific outcome is considered the primary outcome after fast-track THA, clear goals for the rehabilitation must be established before patient selection, intervention type and timing of intervention can be made.</p>