Patient-reported outcomes after hip and knee arthroplasty : results from a large national registry

Emma Louise Heath; Ilana N Ackerman; Kara Cashman; Michelle Lorimer; Stephen E Graves; Ian A Harris

doi:10.1302/2633-1462.26.BJO-2021-0053.R1

Patient-reported outcomes after hip and knee arthroplasty : results from a large national registry

Bone Jt Open. 2021 Jun;2(6):422-432. doi: 10.1302/2633-1462.26.BJO-2021-0053.R1.

Authors

Emma Louise Heath¹, Ilana N Ackerman², Kara Cashman¹, Michelle Lorimer¹, Stephen E Graves^{3

4}, Ian A Harris⁴

Affiliations

¹ South Australian Health and Medical Research Institute, Adelaide, Australia.
² School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Clinical and Health Sciences, University of South Australia, Adelaide, Australia.
⁴ Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, Australia.

PMID: 34182793
PMCID: PMC8244799
DOI: 10.1302/2633-1462.26.BJO-2021-0053.R1

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/m² (SD 7.7) and 32.5 kg/m² (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: Bone Jt Open 2021;2(6):422-432.

Keywords: Arthroplasty; Patient reported outcome measures; Registry science.