Original Articles
The expectations of patients undergoing revision hip arthroplasty**,*

https://doi.org/10.1054/arth.2001.17937Get rights and content

Abstract

Sixty patients were prospectively assessed using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) scale for osteoarthritis of the hip and the Short Form 36 (SF-36) general health status scale as well as the expectation WOMAC, which asked patients to estimate how they expected to feel 6 months after revision hip arthroplasty. There was a wide range of expectations, but we were unable to find any significant correlation between the patients' preoperative pain and stiffness levels and their expectations for pain and stiffness after revision hip arthroplasty. There was no significant correlation between the SF-36 scores and the patients' expectations. Our findings suggest that the expectations of patients awaiting revision hip arthroplasties are high and are not related closely to the level of preoperative disability.

Section snippets

Patients and methods

We prospectively assessed 60 consecutive patients as they were placed on the waiting list for revision THA using the WOMAC scale for osteoarthritis of the hip and the SF-36 general health status scale. The patients were asked to complete the expectation WOMAC. This questionnaire included exactly the same domains as the WOMAC, but the initial wording of the questions was changed, such that it asked the patients to estimate how they expected to feel 6 months after revision THA. All the questions

Results

The patients comprised 18 men and 42 women with an average age of 70 years (range, 37-89 years). The mean preoperative WOMAC score for pain was 13.4 (confidence interval [CI], 12.2-14.6; maximum possible score, 25); for stiffness, 5.9 (CI, 5.6-6.2; maximal possible score, 10); and for physical activity, 50.9 (CI, 47.2-54.6; maximum possible score, 85). The mean expectation WOMAC scores (for which the same potential range of scores is possible) were 7.4 (CI, 6.2-8.6) for pain, 3.5 (CI, 3.0-4.0)

Discussion

There has been great emphasis on the development of measures to determine outcomes after THA 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21. Several studies have assessed and compared different instruments for rating THAs 22, 23, 24, 25. Callaghan et al [24] compared 5 rating systems and found a great disparity in terminology and results. These authors noted no uniformity between the ratings and patients' impressions. Routine scores often are compiled with little regard for the goals and

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    **

    Funds were received from the John Charnley and BOA/Wishbone trusts and the Norman Capener Travelling Fellowship, in support of the research material described in this article.

    *

    Reprint requests: Fares S. Haddad, BSc, 46B MCh(Orth), FRCS(Orth), Hanover Gate Mansions, Park Road, London NW1 4SN, UK.

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