Abstract
This study was performed to assess the relationship between patients’ pre-operative symptoms and their expectations at the time of revision hip arthroplasty. The WOMAC (Western Ontario and McMaster Osteoarthritis Index) scale for osteoarthritis of the hip and the Short Form 36 (SF-36) general health status scale have both been validated for the assessment of the outcome of hip arthroplasty. We prospectively assessed 60 patients using these scales as well as the “expectation WOMAC” that asked the patients to estimate how they expected to feel 6 months after revision hip replacement. All the questions were completed prior to informed consent, and were scored form 1 to 5 with increasing severity with a Likert scale. The maximum possible scores for pain, stiffness and difficulty with physical activity were therefore 25, 10 and 85 respectively.
The mean preoperative WOMAC score for pain was 13.4 (CI 12.2.-14.6), for stiffness 5.9 (CI 5.6-6.2) and for physical activity 50.9 (CI 47.2-54.6) The mean expectation WOMAC scores for these modalities were 7.4 (CI 6.2-8.6), 3.5 (CI 3.0-4.0) and 28.1 (CI 24.0-32.2.) respectively. Although there was a wide spread of expectations, we were unable to find any significant correlation between the patients’ preoperative pain and The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom. stiffness levels and their expectations for pain and stiffness after revision hip arthroplasty. There was however a statistical association between their preoperative difficulty with physical activity and their expectations for physical activity (r=0.38; p=0.02) There was no significant correlation between the SF-36 scores and the patients’ expectations.
The expectations of patients awaiting revision hip replacements are high, and do not appear to be closely related to their level of pre-operative disability. Even patients with severe symptoms have high expectations that in some cases may be unrealistic. The use of the “expectation WOMAC” may help us to identify such patients, and to improve patient education and satisfaction.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
