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Linking Joint-Specific Recovery to Overall Health Through Patient-Reported Outcome Measures: A
Jaeyoung Park1, Emilie N Miley2, Xiang Zhong3
1School of Global Health Management and Informatics, University of Central Florida, Orlando, Florida.
Background:
Patient-reported outcome measures (PROMs) evaluate disease-specific and overall health improvements following total hip and knee arthroplasty (THA/TKA). While disease-specific changes are well documented, the extent to which these procedures influence perceived overall health remains unclear. The aim of this study was to analyze changes in both disease-specific and overall health PROMs from the preoperative visit to 1-year postoperatively in patients who underwent THA and TKA.
Methods:
A retrospective cohort study at a tertiary-care academic center (2016 to 2022) included patients who underwent primary THA or TKA and completed pre- and postoperative PROMs. Propensity score matching balanced the two groups on demographic and clinical variables. Correlations were assessed between changes in Hip dysfunction and Knee injury Osteoarthritis Outcome Score for Joint Replacement (HOOS JR/KOOS JR) and Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-10) subscales (physical health, mental health, and quality of life [QOL]) using Pearson correlation (r) and Spearman's rank coefficients (⍴).
Results:
Matched cohorts included 609 patients who underwent a THA procedure and 609 patients who underwent a TKA procedure. Changes in HOOS JR/KOOS JR were moderately to strongly correlated with physical health (THA: r = 0.63, 95% confidence interval [CI] = [0.58 to 0.68]; TKA: r = 0.56 [CI, 0.51 to 0.62]), but also weakly correlated with mental health (THA: r = 0.33 [CI, 0.26 to 0.40]; TKA: r = 0.24 [CI, 0.16 to 0.31]) and QOL (THA: ⍴ = 0.31 [CI, 0.24 to 0.38]; TKA: ⍴ = 0.22 [CI, 0.15 to 0.30]; all P-values for the correlations <0.001). The correlation strengths did not differ significantly between the THA and TKA groups (physical health: P = 0.088, mental health: P = 0.103); and QOL: P = 0.101).
Conclusions:
These findings support the use of PROMs in evaluating THA and TKA outcomes and emphasize how hip and knee health impacts patient-perceived overall health.
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