Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 2/2010

01-02-2010 | Symposium: Papers Presented at the Hip Society Meetings 2009

Comparing Patient Outcomes After THA and TKA: Is There a Difference?

Authors: Robert B. Bourne, MD, FRCSC, Bert Chesworth, PhD, Aileen Davis, PhD, Nizar Mahomed, MD, FRCSC, Kory Charron, DipMET

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2010

Login to get access

Abstract

Both primary total hip (THA) and knee (TKA) arthroplasty relieve pain, restore function, and increase mobility. Despite these successes, there is controversy as to whether THA or TKA provides greater or similar improvement. We therefore compared primary THA and TKA patient results in terms of (1) willingness to have surgery again; (2) WOMAC change score; (3) whether expectations were met; and (4) satisfaction. Patients undergoing primary THA were more willing to undergo their surgery again (THA 96%, TKA 89%), demonstrated greater WOMAC change scores, more frequently reported their expectations were met (THA 78%, TKA 70%), and expressed greater overall satisfaction (THA 89%, TKA 81%). In addition, patients undergoing THA expressed higher satisfaction with pain reduction while performing activities (ie, walking, stairs, and sitting/lying) and their ability to perform daily activities (ie, stairs, transportation, getting up, lying in bed, and light domestic duties) when compared with patients undergoing TKA. Our data suggest primary THA offers superior short-term outcomes when compared with primary TKA.
Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Literature
2.
go back to reference Anderson JG, Wixson RL, Tsai D, Stulberg SD, Chang RW. Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty. 1996;11:831–840.CrossRefPubMed Anderson JG, Wixson RL, Tsai D, Stulberg SD, Chang RW. Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty. 1996;11:831–840.CrossRefPubMed
3.
go back to reference Bellamy N. WOMAC: a 20-year experiential review of a patient-centered self-reported health status questionnaire. J Rheumatol. 2002;29:2473–2476.PubMed Bellamy N. WOMAC: a 20-year experiential review of a patient-centered self-reported health status questionnaire. J Rheumatol. 2002;29:2473–2476.PubMed
4.
go back to reference Bellamy N. WOMAC Osteoarthritis Index: A User’s Guide IX. London, Ontario, Canada: Professor Nicholas Bellamy; 2009. Bellamy N. WOMAC Osteoarthritis Index: A User’s Guide IX. London, Ontario, Canada: Professor Nicholas Bellamy; 2009.
5.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed
6.
go back to reference Bourne RB, McCalden RW, MacDonald SJ, Mokete L, Guerin J. Influence of patient factors on TKA outcomes at 5 to 11 years follow-up. Clin Orthop Relat Res. 2007;464:27–31.PubMed Bourne RB, McCalden RW, MacDonald SJ, Mokete L, Guerin J. Influence of patient factors on TKA outcomes at 5 to 11 years follow-up. Clin Orthop Relat Res. 2007;464:27–31.PubMed
7.
go back to reference Bourne RB, Sibbald WJ, Doig G, Lee L, Adolph S, Robertson D, Provencher M. The Southwestern Ontario Joint Replacement Pilot Project: electronic point-of-care data collection. Southwestern Ontario Study Group. Can J Surg. 2001;44:199–202.PubMed Bourne RB, Sibbald WJ, Doig G, Lee L, Adolph S, Robertson D, Provencher M. The Southwestern Ontario Joint Replacement Pilot Project: electronic point-of-care data collection. Southwestern Ontario Study Group. Can J Surg. 2001;44:199–202.PubMed
8.
go back to reference Chesworth BM, Mahomed NN, Bourne RB, Davis AM. Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery. J Clin Epidemiol. 2008;61:907–918.CrossRefPubMed Chesworth BM, Mahomed NN, Bourne RB, Davis AM. Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery. J Clin Epidemiol. 2008;61:907–918.CrossRefPubMed
9.
go back to reference Dillman D. Mail and Electronic Surveys: The Tailored Design Method. New York, NY: John Wiley; 2000. Dillman D. Mail and Electronic Surveys: The Tailored Design Method. New York, NY: John Wiley; 2000.
10.
go back to reference Escobar I, Quintana JM, Bilboa A, Arostegai I, Lafuente I, Vidarreta I. Responsiveness and clinically important differences for WOMAC and SF-36 after total knee replacement. Osteoarthritis Cartilage. 2007;15:273–280.CrossRefPubMed Escobar I, Quintana JM, Bilboa A, Arostegai I, Lafuente I, Vidarreta I. Responsiveness and clinically important differences for WOMAC and SF-36 after total knee replacement. Osteoarthritis Cartilage. 2007;15:273–280.CrossRefPubMed
11.
go back to reference Ethgen O, Bruyere O, Richy R, Dardenne C, Reginster JV. Health-related quality of life in total hip and knee arthroplasty. A qualitative and systemic review of the literature. J Bone Joint Surg Am. 2004;86:963–974.PubMed Ethgen O, Bruyere O, Richy R, Dardenne C, Reginster JV. Health-related quality of life in total hip and knee arthroplasty. A qualitative and systemic review of the literature. J Bone Joint Surg Am. 2004;86:963–974.PubMed
12.
go back to reference Fortin PR, Clarke AE, Joseph L, Liang MH, Tanzer M, Ferland D, Phillips C, Partridge AJ, Belisle P, Fossel AH, Mahomed N, Sledge CB, Katz JN. Outcomes of total hip and knee replacement. Preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42:1722–1728.CrossRefPubMed Fortin PR, Clarke AE, Joseph L, Liang MH, Tanzer M, Ferland D, Phillips C, Partridge AJ, Belisle P, Fossel AH, Mahomed N, Sledge CB, Katz JN. Outcomes of total hip and knee replacement. Preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42:1722–1728.CrossRefPubMed
13.
go back to reference Guideline for Wait Time Thresholds for Total Hip and Knee Replacement Surgery Based on Severity. Detailed Report. London, Ontario: Ontario Joint Replacement Registry; 2006. Guideline for Wait Time Thresholds for Total Hip and Knee Replacement Surgery Based on Severity. Detailed Report. London, Ontario: Ontario Joint Replacement Registry; 2006.
14.
go back to reference Janse AJ, Gemke RJ, Uiterwaal CS, van der Tweel I, Kimpen JL, Sinnema G. Quality of life: patients and doctors don’t always agree; a meta-analysis. J Clin Epidemiol. 2004;57:653–661.CrossRefPubMed Janse AJ, Gemke RJ, Uiterwaal CS, van der Tweel I, Kimpen JL, Sinnema G. Quality of life: patients and doctors don’t always agree; a meta-analysis. J Clin Epidemiol. 2004;57:653–661.CrossRefPubMed
15.
go back to reference Jones CA, Voaklander DC, Suarez-Almazon ME. The effect of age on pain, function and quality of life after total hip and knee arthroplasty. Arch Intern Med. 2001;161:454–460.CrossRefPubMed Jones CA, Voaklander DC, Suarez-Almazon ME. The effect of age on pain, function and quality of life after total hip and knee arthroplasty. Arch Intern Med. 2001;161:454–460.CrossRefPubMed
16.
go back to reference Laupacis A, Bourne RB, Rorabeck CH, Feeny D, Wong G, Tugwell P, Leslie K, Bullas R. The effect of elective total hip replacement on health-related quality of life. J Bone Joint Surg Am. 1993;75:1619–1629.PubMed Laupacis A, Bourne RB, Rorabeck CH, Feeny D, Wong G, Tugwell P, Leslie K, Bullas R. The effect of elective total hip replacement on health-related quality of life. J Bone Joint Surg Am. 1993;75:1619–1629.PubMed
17.
go back to reference Mahomed N, Sledge CB, Daltroy L, Fossel A, Katz J. Self-administered satisfaction scale for joint replacement arthroplasty. J Bone Joint Surg Br. 1998;80:63–69.CrossRef Mahomed N, Sledge CB, Daltroy L, Fossel A, Katz J. Self-administered satisfaction scale for joint replacement arthroplasty. J Bone Joint Surg Br. 1998;80:63–69.CrossRef
18.
go back to reference Mahomed NN, Liang MH, Cook EF, Daltroy LH, Fortin PR, Fossel AH, Katz JN. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol. 2002;29:1273–1279.PubMed Mahomed NN, Liang MH, Cook EF, Daltroy LH, Fortin PR, Fossel AH, Katz JN. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol. 2002;29:1273–1279.PubMed
19.
go back to reference Quintana JM, Escobar A, Bilbao A, Arostegai I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after hip joint replacement. Osteoarthritis Cartilage. 2005;13:1076–1083.CrossRefPubMed Quintana JM, Escobar A, Bilbao A, Arostegai I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after hip joint replacement. Osteoarthritis Cartilage. 2005;13:1076–1083.CrossRefPubMed
20.
go back to reference Rorabeck CH, Bourne RB, Laupacis A, Feeny D, Wong C, Tugwell P, Leslie K, Bullas R. A double-blind study of 250 cases comparing cemented with cementless total hip arthroplasty. Cost effectiveness and its impact on health-related quality of life. Clin Orthop Relat Res. 1994;298:156–164.PubMed Rorabeck CH, Bourne RB, Laupacis A, Feeny D, Wong C, Tugwell P, Leslie K, Bullas R. A double-blind study of 250 cases comparing cemented with cementless total hip arthroplasty. Cost effectiveness and its impact on health-related quality of life. Clin Orthop Relat Res. 1994;298:156–164.PubMed
Metadata
Title
Comparing Patient Outcomes After THA and TKA: Is There a Difference?
Authors
Robert B. Bourne, MD, FRCSC
Bert Chesworth, PhD
Aileen Davis, PhD
Nizar Mahomed, MD, FRCSC
Kory Charron, DipMET
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1046-9

Other articles of this Issue 2/2010

Clinical Orthopaedics and Related Research® 2/2010 Go to the issue

Letter to the Editor

Reply to Letter to the Editor

Symposium: Papers Presented at the Hip Society Meetings 2009

Tantalum Components in Difficult Acetabular Revisions

Symposium: Papers Presented at the Hip Society Meetings 2009

Incidence of Groin Pain After Metal-on-Metal Hip Resurfacing