Comparative outcomes of total hip and knee arthroplasty: a prospective cohort study

Postgrad Med J. 2012 Nov;88(1045):627-31. doi: 10.1136/postgradmedj-2011-130715. Epub 2012 Jul 21.

Abstract

Purpose: The comparative outcome of primary hip and knee arthroplasty is not well understood. This study aimed to investigate the outcome and satisfaction of these procedures and determine predictive models for 1 year patient outcome with a view to informing surgical management and patient expectations.

Study design: Prospective cohort study of all primary hip and knee arthroplasty procedures performed at the Royal Infirmary of Edinburgh between January 2006 and November 2008. General health (SF-12) and joint specific function (Oxford Score) was assessed pre-operatively and at 6 and 12 months post-operatively. Patient satisfaction was assessed at 12 months.

Results: 1410 total hip arthroplasty (THA) and 1244 total knee arthroplasty (TKA) procedures were assessed. Oxford Score improved by 4.9 points more in THA patients than in TKA patients. SF-12 physical scores were on average 2.7 points greater in the THA patients at one year. Satisfaction was also greater (91%) following THA compared with TKA (81%). Regression modelling was not able to predict individual patient outcome; however, mean pre-operative Oxford Scores were found to be strong predictors of mean post-operative Oxford Scores for each procedure. Age, gender and pre-operative general health scores did not influence these models.

Conclusions: Both THA and TKA confer substantial improvement in patient outcome; however, greater joint specific, general health and satisfaction scores are reported following THA. This difference is physical in nature. Regression models are presented that can be applied to predict mean hip/knee arthroplasty outcome based on preoperative values.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Arthroplasty, Replacement, Hip / methods
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Arthroplasty, Replacement, Knee / methods
  • Arthroplasty, Replacement, Knee / rehabilitation*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Prospective Studies
  • Quality of Life
  • Recovery of Function
  • Regression Analysis
  • Scotland
  • Severity of Illness Index
  • Treatment Outcome