Patients’ perspectives of outcomes after total knee and total hip arthroplasty: a nominal group study

Abstract

Background: While total joint replacements (TJR) are frequently performed, there is little qualitative research to define the outcomes most important to patients. Methods: Patients who had received total hip (THR) or total knee replacements (TKR) participated in 8 nominal groups to answer the question "What result/results matter the most to a patient undergoing/having a knee or hip replacement?" Total 270 votes were allocated. Results: Eight nominal groups were performed with 45 patients, 6 groups with mean age (71.1 ± 9.3), and 2 with 9 younger patients (mean age 36.8 ± 7.4). All had TJR between 2016 and 2018; overall, 40% were male, 15.6% were Black, and 75% were performed for osteoarthritis. While all groups ranked the same top 3 outcomes, responses varied with age: 1) relief of pain (46% vs. 35% in the young groups); 2) improved function including mobility (29% vs. 18% in the young groups); 3) restored quality of life (13% vs 33% of votes in the younger group). Conclusion: Relief of pain and restoration of function, and improved quality of life are the 3 outcomes ranked highest by patients, confirming their inclusion in TJR clinical trials.

Complications to 6 months following total hip or knee arthroplasty: observations from an Australian clinical outcomes registry

“…Over 90,000 THA and over 1.1 million TKA procedures were undertaken in 2018 in the UK, whilst in the US, incidence is estimated to grow to 572,000 THA and 3.48 million TKA procedures per annum by 2030 [2]. While these procedures are effective in improving pain and function [3][4][5][6][7], there is a risk of complications. The most common complications requiring readmission for hip arthroplasty are dislocation and infection, whereas infection dominates following knee arthroplasty [8,9].…”

Response to Letter to the Editor on “Assessment of a Satisfaction Measure for Use After Primary Total Joint Arthroplasty”

“…Moreover, we specifically questioned the outcomes related to the arthroplasty, not the process of care, and anchored the responses to change in pain and function outcomes permitting psychometrically sound measurement of satisfaction, based on our understanding of this theoretical construct. Our recent work has lent further support to our choice of anchors; patients who had undergone arthroplasty selected improved pain, function, and quality of life as the most important outcomes in open-ended qualitative sessions [5].…”

“…2. Patient-reported outcomes after total knee arthroplasty (Oxford Knee Score) show optimum recovery only by 1 year after surgery which peaks at 2 years [5]. If we look at the literature and recommendations of the working group [6], it is advised to report on early outcomes of total knee arthroplasty only at 1 year of follow-up.…”

Patients' experiences and satisfaction at one year following primary total knee arthroplasty: A focus‐group discussion

“…An effective gold standard end‐stage treatment for knee osteoarthritis is total knee arthroplasty (TKA) (Carr et al, 2012). The main outcomes expected post‐TKA are relief from pain and improved function (Goodman et al, 2020). Satisfaction post‐TKA is significantly less than for post‐total hip arthroplasty (THA).…”