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

Objective. To quantify the magnitude of change seen with pain, function, an d quality of life outcomes 6 months after total hip and knee arthroplasties (THA, TKA) within a community based cohort of a regional health district. Methods. An inception cohort of 504 patients who received primary THA (228) or TKA (276) was prospectively followed. All patients resided in the commu nity and were assessed within one month prior to surgery and 6 months posto peratively. Health related quality of life measures were evaluated with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Medical Outcome Survey Short Form SF-36. Perioperative factors were ex tracted from medical charts. Health services utilization data were collecte d from regional health databases. Results, Over 75% of patients reported improvement in joint-specific pain a nd function, regardless of the type of joint replaced. Other health dimensi ons such as social function, bodily pain, physical function, vitality, and general health showed significant improvement after surgery. Those psychoso cial dimensions with modest changes had baseline values comparable to age a nd sex adjusted normal values; whereas, bodily pain and physical function, which had large changes, had values lower than the normal values. Ninety-on e percent of patients receiving THA were satisfied with their surgery, wher eas 77% were satisfied with their TKA. The average length of stay was 7 day s and the in-hospital complication rate was 0.34 per patient. Conclusion. Large improvements were reported for pain and function after jo int arthroplasties, while small to moderate changes were seen in other area s related to quality of life. Patients with hip arthroplasties showed great er improvement in pain and function and were more satisfied with their outc omes than patients with knee arthroplasties. Although pain and function sho w large improvements, bodily pain and physical function were less than the values reported in the general population.