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Aversion to Total Joint Arthroplasty: Functional Scores Predict Patient Preferences
Orthopedics
|March 20, 2020
Summary
Many patients avoid total hip or knee replacement surgery. Higher pre-operative functional scores, like the Knee injury and Osteoarthritis Outcome Score (KOOS) and Hip disability and Osteoarthritis Outcome Score (HOOS), predict this surgical aversion.
Area of Science:
- Orthopedics
- Patient-reported outcomes
- Surgical decision-making
Background:
- Many patients eligible for total hip arthroplasty (THA) and total knee arthroplasty (TKA) opt to avoid surgery.
- Reasons for surgical avoidance are multifactorial, including prior treatment experiences, living situation, and symptom severity.
Purpose of the Study:
- To investigate if preoperatively collected functional scores can predict patient aversion to total joint arthroplasty (TJA).
Main Methods:
- A prospective cross-sectional survey collected data on demographics, functional scores (HOOS, KOOS, VR-12), radiographic findings, and surgical preference.
- Logistic regression and receiver operating characteristic (ROC) curves were used to identify predictors and cutoffs for surgical aversion.
Main Results:
- 21.4% of patients were averse to surgery; these patients had significantly higher baseline functional scores (KOOS, HOOS).
- Higher functional scores were significantly associated with surgical aversion.
- Optimal KOOS and HOOS cutoff values were identified for predicting aversion.
Conclusions:
- Preoperative functional scores, specifically KOOS and HOOS, are significant predictors of aversion to total joint arthroplasty.
- These scores may aid clinicians in understanding and addressing patient reluctance towards surgical intervention.
