Patient-reported Outcomes After Hip and Knee Arthroplasty : Results from a Large National Registry

Overview

Journal Bone Jt Open

Date 2021 Jun 29

PMID 34182793

Citations 19

Authors

Emma Louise Heath

Ilana N Ackerman

Kara Cashman

Michelle Lorimer

Stephen E Graves

Ian A Harris

Affiliations

Soon will be listed here.

Abstract

Aims: This study aims to describe the pre- and postoperative self-reported health and quality of life from a national cohort of patients undergoing elective total conventional hip arthroplasty (THA) and total knee arthroplasty (TKA) in Australia. For context, these data will be compared with patient-reported outcome measures (PROMs) data from other international nation-wide registries.

Methods: Between 2018 to 2020, and nested within a nationwide arthroplasty registry, preoperative and six-month postoperative PROMs were electronically collected from patients before and after elective THA and TKA. There were 5,228 THA and 8,299 TKA preoperative procedures as well as 3,215 THA and 4,982 TKA postoperative procedures available for analysis. Validated PROMs included the EuroQol five-dimension five-level questionnaire (EQ-5D-5L; range 0 to 100; scored worst-best health), Oxford Hip/Knee Scores (OHS/OKS; range 0 to 48; scored worst-best hip/knee function) and the 12-item Hip/Knee disability and Osteoarthritis Outcome Score (HOOS-12/KOOS-12; range 0 to 100; scored best-worst hip/knee health). Additional items included preoperative expectations, patient-perceived improvement, and postoperative satisfaction. Descriptive analyses were undertaken.

Results: For THA and TKA patients respectively, the patient profile was 2,850 (54.5%) and 4,684 (56.4%) female, mean age 66.8 years (SD 10.6) and 67.5 (SD 8.8), and mean BMI 29.9 kg/m (SD 7.7) and 32.5 kg/m (SD 7.0). The proportion of THA and TKA patients who reported their joint as 'much better' was 2,946 (92.6%) and 4,020 (81.6%) respectively, and the majority of patients were 'satisfied' or 'very satisfied' with their procedure (2,754 (86.5%) and 3,981 (80.8%)). There were 311 (9.7%) of THA patients and 516 (10.5%) of TKA patients who reported 'dissatisfied' or 'very dissatisfied' with their surgery.

Conclusion: Large improvements in pain, function, and overall health were evident following primary THA and TKA. Approximately 10% of patients reported dissatisfaction with their surgery. Future analyses will focus on factors contributing to dissatisfaction after arthroplasty. Cite this article: 2021;2(6):422-432.

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References

de Steiger R, Graves S . Orthopaedic registries: the Australian experience. EFORT Open Rev. 2019; 4(6):409-415. PMC: 6549112. DOI: 10.1302/2058-5241.4.180071. View

Nelson E, Dixon-Woods M, Batalden P, Homa K, Van Citters A, Morgan T . Patient focused registries can improve health, care, and science. BMJ. 2016; 354:i3319. PMC: 5367618. DOI: 10.1136/bmj.i3319. View

Murray D, Fitzpatrick R, Rogers K, Pandit H, Beard D, Carr A . The use of the Oxford hip and knee scores. J Bone Joint Surg Br. 2007; 89(8):1010-4. DOI: 10.1302/0301-620X.89B8.19424. View

Dieppe P, Judge A, Williams S, Ikwueke I, Guenther K, Floeren M . Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres. BMC Musculoskelet Disord. 2009; 10:19. PMC: 2654855. DOI: 10.1186/1471-2474-10-19. View

Gandek B, Roos E, Franklin P, Ware Jr J . A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness. Osteoarthritis Cartilage. 2018; 27(5):754-761. DOI: 10.1016/j.joca.2018.09.017. View

Dawson J, Fitzpatrick R, Carr A, Murray D . Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996; 78(2):185-90. View

Canfield M, Savoy L, Cote M, Halawi M . Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window. Arthroplast Today. 2020; 6(1):62-67. PMC: 7083724. DOI: 10.1016/j.artd.2019.10.003. View

Harris K, Dawson J, Gibbons E, Lim C, Beard D, Fitzpatrick R . Systematic review of measurement properties of patient-reported outcome measures used in patients undergoing hip and knee arthroplasty. Patient Relat Outcome Meas. 2016; 7:101-8. PMC: 4966645. DOI: 10.2147/PROM.S97774. View

Gandek B, Roos E, Franklin P, Ware Jr J . Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12). Osteoarthritis Cartilage. 2018; 27(5):746-753. DOI: 10.1016/j.joca.2018.11.011. View

10.

Franklin P, Miozzari H, Christofilopoulos P, Hoffmeyer P, Ayers D, Lubbeke A . Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States. BMC Musculoskelet Disord. 2017; 18(1):14. PMC: 5225636. DOI: 10.1186/s12891-016-1372-5. View

11.

Rolfson O, Bohm E, Franklin P, Lyman S, Denissen G, Dawson J . Patient-reported outcome measures in arthroplasty registries Report of the Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries Part II. Recommendations for selection, administration, and analysis. Acta Orthop. 2016; 87 Suppl 1:9-23. PMC: 4937770. DOI: 10.1080/17453674.2016.1181816. View

12.

Dormans J, Fisher R, Pill S . Orthopaedics in the developing world: present and future concerns. J Am Acad Orthop Surg. 2001; 9(5):289-96. DOI: 10.5435/00124635-200109000-00002. View

13.

Grassi A, Golinelli D, Tedesco D, Rolli M, Bordini B, Amabile M . Patient-reported outcome measures (PROMs) after elective hip, knee and shoulder arthroplasty: protocol for a prospective cohort study. BMC Musculoskelet Disord. 2019; 20(1):374. PMC: 6694507. DOI: 10.1186/s12891-019-2745-3. View

14.

Gromov K, Greene M, Sillesen N, Troelsen A, Malchau H, Huddleston J . Regional differences between US and Europe in radiological osteoarthritis and self assessed quality of life in patients undergoing total hip arthroplasty surgery. J Arthroplasty. 2014; 29(11):2078-83. DOI: 10.1016/j.arth.2014.07.006. View

15.

Browne J, Bastaki H, Dawson J . What is the optimal time point to assess patient-reported recovery after hip and knee replacement? A systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme. Health Qual Life Outcomes. 2013; 11:128. PMC: 3733605. DOI: 10.1186/1477-7525-11-128. View

16.

Ackerman I, Dieppe P, March L, Roos E, Nilsdotter A, Brown G . Variation in age and physical status prior to total knee and hip replacement surgery: a comparison of centers in Australia and Europe. Arthritis Rheum. 2009; 61(2):166-73. DOI: 10.1002/art.24215. View

17.

Wilson I, Bohm E, Lubbeke A, Lyman S, Overgaard S, Rolfson O . Orthopaedic registries with patient-reported outcome measures. EFORT Open Rev. 2019; 4(6):357-367. PMC: 6549110. DOI: 10.1302/2058-5241.4.180080. View

18.

Dawson J, Fitzpatrick R, Murray D, Carr A . Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998; 80(1):63-9. DOI: 10.1302/0301-620x.80b1.7859. View

19.

Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D . Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011; 20(10):1727-36. PMC: 3220807. DOI: 10.1007/s11136-011-9903-x. View