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When does patient function "Plateau" after total joint arthroplasty? A cohort study.

Seper Ekhtiari1, Tanis Worthy2, Mitchell J Winemaker2,3

  • 1Division of Trauma and Orthopaedic Surgery, Department of Surgery, University of Cambridge, Cambridge, UK.

International Orthopaedics
|July 15, 2024
PubMed
Summary
This summary is machine-generated.

Patient reported outcome measures (PROMs) for hip and knee arthroplasty show significant improvement within six months. After this period, PROMs plateau, indicating limited further gains for total hip arthroplasty and total knee arthroplasty patients.

Keywords:
Minimum clinically important differencePatient reported outcome measuresPlateauTotal Joint Arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Rehabilitation Medicine
  • Health Outcomes Research

Background:

  • Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are highly prevalent procedures in Canada, with over 100,000 performed annually.
  • Existing literature suggests patient-reported outcome measures (PROMs) may plateau between six and 12 months post-surgery.

Purpose of the Study:

  • To analyze the trajectory of PROMs following elective primary THA and TKA.
  • To determine the time point at which PROMs plateau after THA and TKA.
  • To assess the influence of potential confounders on PROM trajectories.

Main Methods:

  • Retrospective analysis of a prospective database.
  • Inclusion criteria: elective primary THA/TKA with pre-operative Oxford Scores and data at minimum two time points (6 weeks, 6 months, 1 year, 2 years).

Main Results:

  • Mean pre-operative Oxford Scores were 18.0 (THA) and 20.1 (TKA).
  • Statistically significant improvements in Oxford Scores were observed from 6 weeks to 6 months, and from 6 months to 1 year for both THA and TKA.
  • No significant interval improvements were found between 1 and 2 years post-surgery for either procedure.

Conclusions:

  • Patients undergoing primary THA or TKA experience clinically meaningful improvements within the first six months.
  • PROMs plateau beyond the six-month mark for both THA and TKA.
  • Findings aid in setting realistic patient expectations pre-operatively and inform surgeons about expected post-operative recovery.