Objective: To examine the effectiveness of orthopaedic surgery in patients with inflammatory arthropathies with regard to longitudinal changes in pain, physical function and health-related quality of life (HRQoL) and explore differences in effectiveness between replacement vs. non-replacement surgery and surgery in the upper vs. lower limb.
Methods: 255 patients (mean (SD) age 57.5 (13.1) years, 76.7 % female) with inflammatory arthropathies underwent orthopaedic surgical treatment and responded to mail surveys at baseline and during follow up (3, 6, 9 and 12 months). The booklet of questionnaires included AIMS2, HAQ, SF-36, EQ-5D and visual analogue scales (VAS) addressing patient global, fatigue, general pain and pain in actual joint. Standardized response means (SRMs) were calculated to estimate magnitude of improvement.
Results: Significant improvement was seen for most of the dimensions of health, largest improvement for pain in actual joint (SRM 1.17) at one year follow up. SRMs for AIMS-2 physical, SF-36 physical and HAQ were 0.1, 0.48 and 0.05 respectively. The overall numeric improvement (SRM) in utility was 0.10 (0.37) with EQ-5D and 0.03 (0.27) with SF-6D. Improvement was overall similar after surgery in upper vs. lower limb, but larger in patients undergoing replacement surgery than in patients undergoing other surgical procedures (SRM 1.54 vs. 1.08 for pain in actual joint).
Conclusions: Surgical procedures have major positive impact on pain in actual joint, but improvement is less in other dimensions of health. Health benefits were larger after replacement surgery than after other surgical procedures.