Journal Article

1-year trajectories of patients undergoing primary total hip arthroplasty: Patient reported outcomes and resource needs according to education level

Gonzalez, Amanda I., Nguyen, Uyen-Sa D. T., Franklin, Patricia, Barea, Christophe, Hannouche, Didier, Lübbeke, Anne

2022

Overview

Background Objectives were first to evaluate by education level one-year trajectories of pain, function and general health, as well as hospital resource and medication needs in patients undergoing primary total hip arthroplasty (THA); and second, to evaluate whether outcome differences are related to existing baseline differences in health and disease severity. Methods We included all primary THAs from a public hospital-based prospective arthroplasty registry, performed in a high-income country 2010 to 2017. Education was classified in three levels: ≤8years of schooling (low), 9-12years (medium), and ≥13years (high). Pain and function prior to and one-year after surgery were assessed with the Western Ontario McMaster Universities score (WOMAC) and general health with the 12-item short-form health survey (SF-12). Results Overall 963 patients were included, 340 (35.3%) with low, 306 (31.8%) with medium, and 317 (32.9%) with high education. With increasing educational level preoperative scores for pain, function and SF-12 mental health component increased. One year after surgery improvement was observed in all education categories for WOMAC pain and function, SF-12 mental and physical component. However, absolute postoperative scores remained lower in all four domains for the low education group. After adjustment for baseline characteristics differences were much attenuated and no longer significant. There was also greater resource need in low educated patients. Conclusions The inferior absolute results one year after surgery in less educated patients were largely due to older age, worse preoperative health and greater symptom severity calling for greater attention to timely and equal management, for more targeted perioperative care and increased support for the lower education group.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Academic achievement / Age / Aged / Analgesics / Arthritis / Arthroplasty / Arthroplasty, Replacement, Hip - adverse effects / Body mass index / Data collection / Diabetes / Education / Epidemiology / Health aspects / Health care access / Hip / Hospitals / Humans / Hypertension / Internal Medicine / Joint replacement surgery / Joint surgery / Length of stay / Medicine / Medicine & Public Health / Mental health / Mortality / Musculoskeletal diseases / Nonsteroidal anti-inflammatory drugs / Orthopedics / Osteoarthritis / Pain / Patient Reported Outcome Measures / Patient reported outcomes / Patients / Postoperative Period / Prospective Studies / Questionnaires / Rehabilitation / Rheumatology / Sports Medicine / Surgery / Systemic diseases / Total hip arthroplasty / Treatment Outcome / Variance analysis