Joint perception after hip or knee replacement surgery

Knee and hip arthroplasties are recognized as being effective. However, subjects with a prosthetic joint rarely report returned sensation comparable to their native joint.

Joint perception by patients following hip joint replacement is better than following knee replacement and in both cases this perception is directly related to the clinical results measured with currently validated scores.

Patient joint perception in prosthetic reconstruction was evaluated in 347 patients, 46 who underwent unicompartmental knee arthroplasty (UKA), 119 tricompartmental knee arthroplasty (TKA), 93 hip resurfacing (HR), and 89 total hip arthroplasty (THA). The subjects' joint perception, their satisfaction, and the WOMAC clinical score were recorded and compared.

Joint perception was significantly worse for knee arthroplasties (TKA and UKA) compared to hip arthroplasties (THA or HR) (P<0.001). The WOMAC score was also significantly less favorable for knee arthroplasties than for hip arthroplasties (P<0.0001). However, there was no significant difference for the clinical scores between TKA and UKA as well as between HR and THA. Joint perception was strongly correlated with the WOMAC score for all groups (R(2)=0.951).

No difference was found after more conservative surgeries such as HR or UKA compared to traditional arthroplasty procedures (THA or TKA). Demonstrating inferior results in comparison to the hip, knee arthroplasties deserve particular attention and can still be improved. The assessment of joint perception used in this study can be considered a valuable clinical tool that is strongly correlated to validated, but more complex to apply, clinical scores.