ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY

J. I. Huddleston; A. F. Chen; J. A. Browne; H. Jaffri; D. S. Weitzman; K. J. Bozic

doi:10.1302/1358-992X.2019.12.021

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ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY

The Hip Society (THS) 2019 Summer Meeting, Kohler, WI, USA, 25–27 September 2019.

J. I. Huddleston
A. F. Chen
J. A. Browne
H. Jaffri
D. S. Weitzman
K. J. Bozic

ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY

Huddleston JI, Chen AF, Browne JA, Jaffri H, Weitzman DS, Bozic KJ. ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY. Orthop Procs. 2019;101-B(SUPP_12):21-21. doi:10.1302/1358-992X.2019.12.021

Huddleston, J. I., et al. “ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings, vol. 101-B, no. SUPP_12, 2019, pp. 21-21., https://doi.org/10.1302/1358-992X.2019.12.021

Huddleston, J. I., Chen, A. F., Browne, J. A., Jaffri, H., Weitzman, D. S., & Bozic, K. J. (2019). ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY. Orthopaedic Proceedings, 101-B(SUPP_12), 21-21. https://doi.org/10.1302/1358-992X.2019.12.021

Huddleston, J. I., Chen, A. F., Browne, J. A., Jaffri, H., Weitzman, D. S. and Bozic, K. J. (2019) “ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings, 101-B(SUPP_12), pp. 21-21. Available at: https://doi.org/10.1302/1358-992X.2019.12.021

Huddleston, J. I., A. F. Chen, J. A. Browne, H. Jaffri, D. S. Weitzman, and K. J. Bozic. “ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY.” Orthopaedic Proceedings 101-B, no. SUPP_12 (2019): 21-21. https://doi.org/10.1302/1358-992X.2019.12.021

Huddleston JI, Chen AF, Browne JA, Jaffri H, Weitzman DS, Bozic KJ. ACHIEVEMENT OF MEANINGFUL IMPROVEMENT OF PATIENT-REPORTED OUTCOME MEASURES FOLLOWING TOTAL HIP ARTHROPLASTY. Orthop Procs. 2019 Oct 1;101-B(SUPP_12):21-21. https://doi.org/10.1302/1358-992X.2019.12.021

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Abstract

Introduction

Meaningful clinical improvement as demonstrated through patient-reported outcome measures (PROMs) are increasingly used to evaluate success of total hip arthroplasty (THA) procedures. This patient perspective can provide a full picture when used with clinical data to best evaluate surgical outcomes.

Methods

All primary THA procedures reported to the American Joint Replacement Registry from 2012–2018 with linked pre-operative and 1-year post-operative functional or anatomical PROMs were included. The achievement of minimal clinically-important difference (MCID) was calculated using the distribution method. Logistic regression models with covariate adjustment for patient demographics, American Society of Anesthesiologists (ASA) score, and body mass index (BMI) were constructed to identify associations with PROMs. Results were analyzed based on hospital size (small, medium and large) and teaching type (non-teaching, minor and major) based on the American Hospital Association Survey (2015).

Results

There were 3,952 THA with pre-operative and 1-year post-operative PROMs. The five types of PROMs collected include: HOOS (n=731), HOOS Jr. (n=295), PROMIS-10 (n=1,074), SF-36 (n=976), VR-12 (1,262). The average age was 66.3±10.5 years, and the majority were female (54.7%). 53.1% of THA patients achieved MCID. Age and gender were statistically significant, while ASA score and BMI classification were not. As age increased by 1 year, the odds of achieving MCID increased 0.8% (OR 0.992, 95%CI 0.984, 0.999) and a minor versus major teaching hospital was 20.8% less likely to achieve MCID (p<0.04). While small hospital sizes had significantly fewer linked PROMs (6.5% of all linked PROMs), only 44.5% achieved MCID compared to medium (52.3%) and large (54.5%) hospitals (p<0.02).

Conclusion

Older patient age, major teaching hospitals, and large hospitals achieved higher levels of MCID after THA. Identifying patients that are less likely to achieve MCID can aid physicians by determining patients at risk for poor outcomes, then guiding patient expectations and providing patient-centered care.

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