We used prospective data from 862 total knee and 716 total hip replacements three years after surgery in order to derive and validate a reduced Western Ontario and McMasters University Osteoarthritis Index (WOMAC) function scale. The reduced scale was derived using the advice of clinical experts as well as analysis of data. The scale was tested for validity, reliability and responsiveness.

Items which were retained included: ascending stairs, rising from sitting, walking on the flat, getting in or out of a car, putting on socks, rising from bed, and sitting.

The reduced and full scales had comparable, moderate correlations with other measures of function, confirming convergent validity. Cronbach’s alpha was high (α > 0.85) with the reduced scale confirming reliability. Responsiveness was greater for the reduced scale (full = 1.4, reduced = 1.6).

This reduced version of the WOMAC function scale provides a practical, valid, reliable and responsive alternative to the full function scale for use after total joint replacement. Further work is needed to demonstrate its wider applicability.

We describe a modified lateral approach to the hip which exploits the functional continuity of gluteus medius and vastus lateralis and their dense crescentic attachment to the greater trochanter. The gluteus medius is not incised or split, but is detached and mobilised with gluteus minimus as one unit. This facilitates reattachment of the glutei and helps to preserve abductor function.