Quality-of-Life Improvement Compared After Hip and Knee Replacement

Abstract

T otal hip and total knee arthroplasty both provide a considerable improvement in quality of life, but there is no evidence to suggest that one is more successful than the other. We studied 72 patients in a prospective trial before and after total hip or total knee replacement. We recorded scores for disability and distress derived from the Harris hip score and the British Orthopaedic Association knee assessment score, and used them to generate quality of life (QoL) scores using the Rosser Index Matrix immediately before and at one year after surgery.The patients awaiting knee replacement had significantly lower QoL scores than those awaiting hip replacement (p = 0.011). The QoL scores at one year were high and almost identical for both groups (p = 0.46). Further analysis showed that gender and weight were not significant predictors of improvement of QoL scores, but age (p = 0.03) and whether the hip or knee was replaced (p = 0.006) were significant factors.

The Effect of Total Knee Replacement on Employment in Patients Under 60 Years of Age

“…The total knee replacement operation significantly improved the functional ability of these patients and it also facilitated a return to work for these 11 patients. 25 Our series did not show a return to work in patients that were unemployed pre-operatively.…”

“…23,24 However, increased knee pain, reduced range of movement and lower functional outcome scores have all been reported in patients receiving worker compensation. [21][22][23][24] Norman-Taylor et al 25 studied both hip and knee surgery patients and described changes in employment after surgery. Eleven out of 31 patients before total knee replacement operation were described with a Rosser index of IV or more, which signified severe impairment of work duties or unemployment.…”

Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis

“…restores function and provides pain relief and improved quality of life in patients with OA (5)(6)(7)(8). These procedures are usually reserved, however, for patients with functional impairment in whom exercise, weight loss, activity modification, medication, and physical therapy are no longer effective (2).…”

Pain Relief and Functional Improvement Remain 20 Years After Knee Arthroplasty

“…While TKA provides pain relief and an improved healthrelated quality of life [7,8,12,20], physical function may decline over time even with what would otherwise be considered a successful long-term outcome of a TKA [24]. The extent of this decline in physical function, independent of prosthetic function, has important implications with respect to ensuring the success of a TKA into the third decade of implantation.…”

“…An NIH Consensus Panel on TKA concluded substantial improvements in patient's pain, function, and overall health-related quality of life continue in up to 90% of patients, with 85% of patients being satisfied with the result of the arthroplasty [19]. These improvements may include enhancements in physical, mental, and social aspects of patient's lives such as pain relief, mobility, activities of daily living, disability, and economic status [7,12,20].…”