Health-Related Quality of Life in Total Hip and Total Knee Arthroplasty

Ethgen, Olivier; Bruyère, Olivier; Richy, Florent; Dardennes, Charles; Reginster, Jean‐Yves

doi:10.2106/00004623-200405000-00012

Cited by 1,627 publications

(1,206 citation statements)

References 91 publications

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“…In agreement with previous work (1), this large cohort study of patients receiving primary THR for OA in European orthopedic centers demonstrates that 12 months after surgery, there is a large average improvement in patients' pain and disability. However, the data also show that although the majority of patients received symptomatic improvement, there was an important group of ϳ14 -36% of patients who experienced little or no improvement after surgery.…”

Section: Discussionsupporting

confidence: 92%

“…It has been shown to be highly cost effective and very good at relieving pain and disability as well as improving quality of life (1)(2)(3)(4). It is also among the most frequently used elective surgical procedures (ϳ170,000/year in Germany [5], ϳ70,000/year in England [6], and ϳ500,000/year in the US [7]).…”

Section: Introductionmentioning

confidence: 99%

“…Most studies that report such data have treated the outcome measure as a continuous variable, and simply recorded the mean scores before and after surgery (1). These have shown a marked improvement in the mean score as a result of surgery, but have not revealed individual patient gains or losses in pain and function.…”

Section: Introductionmentioning

confidence: 99%

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Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Judge¹,

Cooper²,

Williams³

et al. 2010

Arthritis Care & Research

133

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Results. On average, there was a large improvement in WOMAC scores 12 months after surgery, but whereas some patients improved, others got worse. The OMERACT-OARSI method classified 85.7% of patients as responders, MID 70.1%, and return to normal 64.1%. In general, each approach classified the same groups of patients as responding to THR. Based on total WOMAC score, patients who were younger, morbidly obese, employed, and better educated were more likely to respond to THR, but the effects were attenuated after adjustment for confounding, with only the effect of education remaining important. Conclusion. The overall average response to THR was good, but ϳ14 -36% of patients did not improve, or were worse, 12 months postsurgery. Although the OMERACT-OARSI criteria were originally designed for use in clinical drug trials, they performed well in classifying patient response 12 months post-THR. Further research is required to understand the determinants of patient outcomes following THR.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Judge¹,

Cooper²,

Williams³

et al. 2010

Arthritis Care & Research

133

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“…Despite increasing demand for TKAs and cost-effectiveness of the procedure [11,16,17], a substantial number of patients who undergo a TKA are dissatisfied with the outcomes, with reported satisfaction rates varying between 75% and 89% [1,6,7,23,24,36,41,51], regardless of patient demographics or severity of disease.…”

Section: Introductionmentioning

confidence: 99%

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Khatib

Madan

Naylor

et al. 2015

Clinical Orthopaedics &Amp; Related Research

162

114

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Background A subgroup of patients undergoing TKA is unhappy with the outcome of surgery and preoperative psychological factors may play a role in their dissatisfaction. Questions/purposes We asked whether (1) psychological factors, as measured by preoperative self-reported questionnaires, predicted poor outcome after TKA, and (2) whether certain psychological factors examined predicted poor outcome better than others. Methods We performed a systematic review and metaanalysis of prospective observational studies published in MEDLINE, CINAHL 1 , EMBASE TM , and PsycINFO 1 databases from their date of inception to October 2013, augmented with a manual search of bibliographies. Study eligibility was performed according to an a priori protocol. Included studies were assessed for quality according to the Newcastle-Ottawa scale. Two reviewers independently performed the search, identified eligible studies, assessed their methodologic quality, and extracted data. Outcomes of interest included postoperative dissatisfaction, pain, or limited function of the patients.

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“…Osteoarthritis (OA) is the most common reason for joint replacement surgery, and in Finland, OA accounted for 90% of 10,438 primary total knee replacement procedures performed in 2006 (3). Although a majority of patients experience marked improvement in pain, physical function, and quality of life after total knee arthroplasty (TKA) (4,5), all of the significant defects in muscle strength, aerobic fitness, and quality of life do not spontaneously resolve after surgery (6 -8). Therefore, it is essential that patients receive effective rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial

Kauppila

Sintonen

Aronen

et al. 2011

Arthritis Care & Research

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Objective. To conduct an economic evaluation of a multidisciplinary, biopsychosocial outpatient rehabilitation program implemented 2-4 months after total knee arthroplasty (TKA), compared with conventional orthopedic care. Methods. After surgery, 86 patients were randomized to a multidisciplinary rehabilitation group (n ‫؍‬ 44) or a conventional orthopedic care group (n ‫؍‬ 42). Alongside the randomized controlled trial, we estimated the costs of rehabilitation, health care resource use, and community support. Information about resource use was collected by means of a questionnaire together with data from hospital records. The primary outcome (effectiveness) measure was change in self-reported functional capacity and the secondary measure was quality-adjusted life years (QALYs) gained during the 12-month followup. Cost-effectiveness was assessed from between-group differences in costs, change in functional capacity, and QALYs gained. Results. Both protocols of providing rehabilitation services turned out to be equally effective, but the conventional orthopedic care protocol was unequivocally cost saving: the saving was €1,830 per patient (95% confidence interval ؊548, 3,623) using the available direct cost data. Conclusion. Multidisciplinary rehabilitation for unselected osteoarthritis patients in the subacute period of recovery after TKA is not a cost-effective use of health care resources. Similar rehabilitation protocols cannot be recommended for clinical pathways of TKA in the future.

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Health-Related Quality of Life in Total Hip and Total Knee Arthroplasty

Cited by 1,627 publications

References 91 publications

Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial

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