scholarly journals Patient-reported outcomes after hip and knee arthroplasty

2021 ◽  
Vol 2 (6) ◽  
pp. 422-432
Author(s):  
Emma Louise Heath ◽  
Ilana N. Ackerman ◽  
Kara Cashman ◽  
Michelle Lorimer ◽  
Stephen E. Graves ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Profile ◽  
Patient Reported ◽  
Before And After ◽  
Hip And Knee Arthroplasty ◽  
National Cohort ◽  
Five Dimension ◽  
Preoperative Expectations

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.

scholarly journals The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty

2020 ◽  
Vol 102-B (7) ◽  
pp. 950-958 ◽  
Author(s):  
H. Dakin ◽  
P. Eibich ◽  
D. Beard ◽  
A. Gray ◽  
A. Price
Keyword(s):  
Cost Effectiveness ◽  
Knee Arthroplasty ◽  
Cost Effective ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Quality Adjusted Life Year ◽  
Sensitivity Analyses ◽  
Patient Reported ◽  
Hip And Knee Arthroplasty ◽  
The Cost

Aims To assess how the cost-effectiveness of total hip arthroplasty (THA) and total knee arthroplasty (TKA) varies with age, sex, and preoperative Oxford Hip or Knee Score (OHS/OKS); and to identify the patient groups for whom THA/TKA is cost-effective. Methods We conducted a cost-effectiveness analysis using a Markov model from a United Kingdom NHS perspective, informed by published analyses of patient-level data. We assessed the cost-effectiveness of THA and TKA in adults with hip or knee osteoarthritis compared with having no arthroplasty surgery during the ten-year time horizon. Results THA and TKA cost < £7,000 per quality-adjusted life-year (QALY) gained at all preoperative scores below the absolute referral thresholds calculated previously (40 for OHS and 41 for OKS). Furthermore, THA cost < £20,000/QALY for patients with OHS of ≤ 45, while TKA was cost-effective for patients with OKS of ≤ 43, since the small improvements in quality of life outweighed the cost of surgery and any subsequent revisions. Probabilistic and one-way sensitivity analyses demonstrated that there is little uncertainty around the conclusions. Conclusion If society is willing to pay £20,000 per QALY gained, THA and TKA are cost-effective for nearly all patients who currently undergo surgery, including all patients at and above our calculated absolute referral thresholds. Cite this article: Bone Joint J 2020;102-B(7):950–958.

scholarly journals The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty

2020 ◽  
Vol 102-B (7) ◽  
pp. 941-949 ◽  
Author(s):  
Andrew J. Price ◽  
Sujin Kang ◽  
Jonathan A. Cook ◽  
Helen Dakin ◽  
Ashley Blom ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Secondary Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Meaningful Improvement ◽  
Score Threshold ◽  
Patient Reported ◽  
Hip And Knee Arthroplasty ◽  
Definition Of

Aims To calculate how the likelihood of obtaining measurable benefit from hip or knee arthroplasty varies with preoperative patient-reported scores. Methods Existing UK data from 222,933 knee and 209,760 hip arthroplasty patients were used to model an individual’s probability of gaining meaningful improvement after surgery based on their preoperative Oxford Knee or Hip Score (OKS/OHS). A clinically meaningful improvement after arthroplasty was defined as ≥ 8 point improvement in OHS, and ≥ 7 in OKS. Results The upper preoperative score threshold, above which patients are unlikely to achieve any meaningful improvement from surgery, is 41 for knees and 40 for hips. At lower scores, the probability of improvement increased towards a maximum of 88% (knee) and 95% for (hips). Conclusion By our definition of meaningful improvement, patients with preoperative scores above 41 (OKS) and 40 (OHS) should not be routinely referred to secondary care for possible arthroplasty. Using lower thresholds would incrementally increase the probability of meaningful benefit for those referred but will exclude some patients with potential to benefit. The findings are useful to support the complex shared decision-making process in primary care for referral to secondary care; and in secondary care for experienced clinicians counselling patients considering knee or hip arthroplasty, but should not be used in isolation. Cite this article: Bone Joint J 2020;102-B(7):941–949.

scholarly journals Association of handgrip strength with patient-reported outcome measures after total hip and knee arthroplasty

2020 ◽  
Vol 40 (4) ◽  
pp. 565-571 ◽  
Author(s):  
Jennifer M. T. A. Meessen ◽  
Marta Fiocco ◽  
Rutger L. Tordoir ◽  
Arnout Sjer ◽  
Suzan H. M. Verdegaal ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Handgrip Strength ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Total Hip ◽  
Patient Reported ◽  
Hip And Knee Arthroplasty

scholarly journals Validity of the French version of Catquest-9SF and use of an electronic notepad for entering patient-reported outcome measures

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Gregory Katz ◽  
Alexandra Rouquette ◽  
François Lignereux ◽  
Thierry Mourgues ◽  
Michel Weber ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Psychometric Properties ◽  
Rasch Analysis ◽  
Item Difficulty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Good Precision ◽  
French Version ◽  
Patient Reported ◽  
Before And After

Abstract Background The Catquest-9SF questionnaire is a patient reported outcome measure that quantifies the visual benefits from cataract surgery. The purpose of this study was to translate and adapt the Catquest-9SF questionnaire for France, to assess its psychometric properties via Rasch analysis, and to assess its validity when completed using an electronic notepad. Methods The Catquest-9SF questionnaire was translated following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Catquest-9SF and clinical data were collected from patients before and after routine cataract surgery. All questionnaire data were collected via an electronic notepad. Rasch analysis was performed to assess psychometric properties, and sensitivity to change was analysed for patients with complete paired pre- and post-operative questionnaires. Results A complete filled-in preoperative questionnaire was obtained for 848 patients. Rasch analysis showed good precision (person separation: 2.32, person reliability: 0.84), ordered category probability curves, no item misfit, and unidimensionality. The respondents were slightly more able than the level of item difficulty (targeting: −1.12 logits). Sensitivity was analysed on 211 paired questionnaires, and the postoperative questionnaires showed a clear ceiling effect. The effect size was 2.6. The use of an electronic notepad for completing the questionnaire worked out very well after some adjustments. Conclusions The French version of Catquest-9SF has good psychometric properties and is suitable for use in French-speaking patients. The use of the Catquest-9SF questionnaire in an electronic format showed good validity.

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