Abstract
Introduction
US payers offer incentives to hospitals to report patient-reported outcomes measures (PROMs) for total hip arthroplasty (THA). We report THA norms for pre-op and one-year PROMs in a large multi-center cohort and compare global, hip specific scores, and abbreviated PROM measures acceptable to meet payer requirements. The HOOS 12 is a new form of the HOOS containing 12 questions that allows separate determination of pain and ADL sub-scores in addition to the total score.
Methods
Between 2011–2015, 7895 primary elective THA patients enrolled in the FORCE-TJR research consortium from over 200 surgeons in 28 states. Patients completed pre-op demographics, clinical risks, PROMs, and one-year outcomes. Over 95% completed pre-op PROMs; 83% post-op. Generic and hip specific (HOOS full and HOOS-12 sub-scores, and HOOS JR global) PROMs were compared.
Results
THA patients were 57% female and 49% <65 years. Mean BMI was 29.7 (5.2), 15.5% with BMI>35. Mean (SD) pre-op generic scores: SF-PCS= 31.3 (8.5), HOOS JR= 45.5 (16.2). Pre-op Sub-scores: HOOS full and HOOS12 pain mean = 41.9 (18.6), HOOS full ADL= 44.2 (19.4), HOOS12 ADL= 40.9 (19.7). Mean (SD) 1 yr PROMs: SF-PCS= 45.6(9.8), Pre-post PCS change= 14.1 (9.6).
Conclusions
THA patients improved significantly on all PRO measures but HOOS full and HOOS12 scores show greater pre-post change than the HOOS JR. Surgeons may consider PRO brevity, relevance in clinical care, and change magnitude when choosing which PRO to report. The HOOS and HOOS12 full and sub- scores demonstrate the highest scores at one year and the greatest improvement from pre-op score.
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