DIFFERENCES BETWEEN PATIENTS AND PHYSICIANS EVALUATIONS OF OUTCOME AFTER TOTAL HIP-ARTHROPLASTY

The purpose of this study was to compare patients' and physicians' eva luations of the results of 147 total hip arthroplasties, The patients and physicians independently evaluated pain and over-all satisfaction, vith the outcome of the procedure using a 10.0-centimeter visual-analo g scale, They also answered a questionnaire with which they assessed g eneral health, functional ability, and pain, The mean (and standard de viation) analog rating for pain (with 0.0 centimeters indicating no pa in and 10.0 centimeters, severe pain) was 1.7 +/- 2.6 centimeters as a ssessed by the patients and 1.1 +/- 1.8 centimeters as assessed by the physicians (p < 0.001, paired t test), The mean analog rating for ove r-all satisfaction (with 0.0 centimeters indicating poor and 10.0 cent imeters, excellent) was 8.6 +/- 2.1 centimeters as assessed by the pat ients and 8.8 +/- 1.7 centimeters as assessed by the physicians (p = 0 .07, paired t test), There was a marked disparity between the patients ' and the physicians' scores when the patients assigned a low score to a particular area, For the thirty patients who rated the pain as more than 4.0 centimeters, the mean analog rating was 6.8 +/- 2.1 centimet ers according to the patients, while it was 3.6 +/- 2.7 centimeters ac cording to the physicians (p < 0.001, linear regression), The mean ana log rating for over-all satisfaction according to the nineteen patient s who rated this parameter as less than 7.0 centimeters was 3.8 +/- 2. 0 centimeters, while the mean rating according to the physicians was 6 .5 +/- 2.8 centimeters (p < 0.001, linear regression), The patients' a nd physicians' evaluations were similar regarding the results of the t otal hip arthroplasty when the patients had little or no pain and were satisfied with the result. However, the disparity increased as the pa tients' ratings for pain increased and their ratings for over-all sati sfaction decreased. This study highlights a discrepancy between patien ts' and physicians' evaluations of the results of total hip arthroplas ty. This discrepancy increased when the patient was not satisfied with the outcome, The use of patients' self-administered questionnaires as well as traditional physician-generated assessments may provide a mor e complete evaluation of the results of total hip arthroplasty.