Appraisal and patient-reported outcomes following total hip arthroplasty: a longitudinal cohort study

Abstract

Background Total hip arthroplasty (THA) is a successful procedure that provides pain relief, restores function, and improves quality of life (QOL) for patients with advanced arthritis in their hip joint. To date, little research has examined the role of cognitive appraisal processes in THA outcomes. This study examined the role of cognitive appraisal processes in THA outcomes in the first year post-surgery. Methods This longitudinal cohort study collected data at pre-surgery, 6 weeks post-surgery, 3 months post-surgery, and 12 months post-surgery. Adults (n = 189) with a primary diagnosis of osteoarthritis were consecutively recruited from an active THA practice at a Canadian academic teaching hospital. Measures included the Hip Disability and Osteoarthritis Outcome Score (HOOS), the Mental Component Score (MCS) of the Rand-36, and the Brief Appraisal Inventory (BAI). Analysis of Variance examined the association between BAI items and the HOOS or MCS scores. Random effects models investigated appraisal main effects and appraisal-by-time interactions for selected BAI items. Results HOOS showed great improvement over the first 12 months after THA, and was mitigated by three appraisal processes in particular: focusing on problems with healthcare or living situation, and preparing one’s family for health changes. MCS was stable and low over time, and the following appraisal processes were implicated by very large effect sizes: not comparing themselves to healthier people, focusing on money problems, preparing their family for their health changes, or trying to shed responsibilities. Conclusions Appraisal processes are relevant to health outcomes after THA, with different processes coming into play at different points in the recovery trajectory.

Cognitive Processes during Recovery: Moving toward Personalized Spine Surgery Outcomes

“…In contrast, the MCS showed notable but lesser improvement than the ODI over the first 12 months after surgery and then plateaued. These findings were similarly seen in a total hip arthroplasty population between a disease-specific outcome measure (the Hip Disability and Osteoarthritis Outcome Score [ 36 ]) and the MCS [ 37 ]. Of note, the relationship between these two outcomes varied over follow-up: they were uncorrelated at baseline and became more strongly correlated over time.…”

Optimizing Acetabular Positioning: A Comprehensive Review of Contemporary Strategies in Total Hip Arthroplasty

“…Findings revealed that specific appraisal processes, such as focusing on healthcare or living situation problems, were linked to worse outcomes in the initial six weeks post-THA. Conversely, other appraisal processes, like preparing one's family for health changes, correlated with improved outcomes during the same period [ 52 ]. In terms of short-term outcomes, a study examining the short-term results of total hip replacement (THR) identified patients experiencing functional recovery alongside those encountering treatment failure.…”