Elsevier

The Journal of Arthroplasty

Volume 26, Issue 2, February 2011, Pages 209-213
The Journal of Arthroplasty

Predicting Dissatisfaction After Total Hip Arthroplasty: A Study of 850 Patients

https://doi.org/10.1016/j.arth.2010.03.013Get rights and content

Abstract

We conducted a prospective cohort study investigating the rate and predictors of dissatisfaction among patients after primary total hip arthroplasty (THA). Eight hundred fifty patients were assessed preoperatively and 1 year postoperatively using Patient Reported Outcome Measures. There was a 7% rate of dissatisfaction after THA. After univariate analysis, depression, preoperative Short Form 12 mental component score, and symptomatic arthritis of another major joint predicted dissatisfaction at 1 year, but after multivariate analysis, only symptomatic arthritis in another major joint was significant. The development of a major complication did not predict dissatisfaction. Satisfaction also correlates strongly with postoperative functional scores, relief of pain, restoration of function, and success in meeting patient expectations. Pain relief and expectation management are critical in maximizing patient satisfaction after THA.

Section snippets

Patients and Methods

Institutional review board approval was obtained for this study. We carried out a single-center prospective cohort study of 907 consecutive patients listed for primary THA between 2003 and 2008. Patients were included if they were older than 18 years, undergoing primary THA, and were able to consent to the study. Recruitment was carried out at a consultant-lead preadmission clinic 2 weeks before surgery. At this consultation, detailed data on comorbidity (hypertension, diabetes, ischemic heart

Statistical Analysis

Continuous data were checked for normality with histograms. The Student t test was used to compare parametric continuous data including OHS, SF-12 physical component scores (PCS), SF-12 mental component scores (MCS), and the change in these scores at 12-month assessment. χ2 tests were used to compare data for comorbidities, complications, the surgical approach used, and satisfaction. Potential predictive factors that reached a level of significance where P < .10 after univariate analysis were

Results

A total of 907 consecutive patients who underwent 939 primary THAs were recruited. At 1 year, we were able to review 850 patients (93.7%) who had undergone 882 THAs. These patients formed the study group. There were no statistically significant differences in the preoperative data responses between patients attending for follow-up and those defaulting. The mean patient age was 68.3 years (range, 54-99; SD, 10.4). The primary diagnosis was osteoarthritis for 694 hips (78.7%) and an inflammatory

Discussion

The aims of this study were to determine the incidence of dissatisfaction after THA and to investigate the relationship of dissatisfaction with patient-reported function. This study established an overall incidence of dissatisfaction of 7% 1 year after THA. To our knowledge, these data have not been previously available specifically for THA. In keeping with other studies, we did not find that age or sex were predictive for satisfaction after joint arthroplasty 5, 9, 10, 11.

Preoperative mental

Acknowledgments

We would like to thank Ms Deborah McDonald who has coordinated the arthroplasty research program at the Royal Infirmary, Edinburgh, and the University of Edinburgh.

References (18)

  • JonesC.A. et al.

    Total joint arthroplasties: current concepts of patient outcomes after surgery

    Rheum Dis Clin North Am

    (2007)
  • MancusoC.A. et al.

    Patients' expectation and satisfaction with total hip arthroplasty

    J Arthroplasty

    (1997)
  • WaltonM.J. et al.

    Pre-operative mental wellbeing and the outcome of knee replacement

    Knee

    (2008)
  • WiklundI. et al.

    A comparison of quality of life before and after arthroplasty in patients who had arthrosis of the hip joint

    J. Bone Joint Surg

    (1991)
  • NgC.Y. et al.

    Quality of life and functional outcome after primary total hip replacement. A five-year follow-up

    J Bone Joint Surg

    (2007)
  • JonesC.A. et al.

    Health related quality of life outcomes after total hip and knee arthroplasties in a community based population

    J Rheumatol

    (2000)
  • NobleP.C. et al.

    The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty

    Clin Orthop Relat Res

    (2006)
  • MahomedN.N. et al.

    The importance of patient expectations in predicting functional outcomes after total joint arthroplasty

    J Rheumatol.

    (2002)
  • JenkinsonC. et al.

    A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity

    Med Care

    (1996)
There are more references available in the full text version of this article.

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No benefits or funds were received in support of the study.

The authors declare that they have no conflict of interest.

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