Abstract
Our ongoing aim is to assess the clinical outcome of joint replacement surgery; we wish to contrast the functional outcome of primary and revision patients, and examine what factors may influence this.
Method: Patient data was collected prospectively between Jan 1998 and April 2006. The assessment scores include, the Harris Hip Score, Knee Society Score, SF 36 Health Survey and WOMAC. We compare the pain and function parts of the Knee Society Score for Primary and Revision TKR and the Harris Hip Score for Primary and Revision THR.
Results: The Harris Hip Score improves significantly up to one-year post surgery, with the largest increase occurring at three months. Post surgery improvement then plateaus between one and two years and between two and five years. Revision hip replacement patients display a significant improvement in the Harris Hip Score at three months post surgery, but improvement plateaus after this up to two years. These results are presented graphically.
The Knee Society Score in primary total knee replacement patients improves significantly over time up to one-year post surgery for all components of the score, with the largest increase occurring at three months. Post surgery improvement then plateaus between 1 and 2 years. At 5 years post op both the total score and the function score significantly decrease while there is no change in the knee score component. All components of the Knee Society Score measured in revision knee replacement patients significantly improve at three months post surgery, after which time no further significant improvement is noted.
Discussion: Primary THR patients consistently had higher hip scores than revision patients at all time frames, indicating a better outcome for these patients. When stratified for reason for revision we postulate that a number of well functioning patients are significantly worse following revision surgery. This effect is not seen in the revision TKR group. The decrease in Knee Society Score to five years probably reflects the age of the patients at the time of surgery, which is older than hip replacement patients.
The abstracts were prepared by Mr D J Bracey, Editorial Secretary. Correspondence should be addressed to him at Royal Cornwall Hospital, Treliske, Cornwall TR1 3LJ, England.
