Patients' experience on pain outcomes after hip arthroplasty: insights from an information tool based on registry data.

Journal: BMC musculoskeletal disorders

Volume: 25

Issue: 1

Year of Publication: 

Affiliated Institutions:  Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. Division of Orthopaedics & Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland. Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland. Division General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland. Centre for Health Economics, University of York, York, UK. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. rafael.pinedo@ndorms.ox.ac.uk.

Abstract summary 

Arthroplasty registries are rarely used to inform encounters between clinician and patient. This study is part of a larger one which aimed to develop an information tool allowing both to benefit from previous patients' experience after total hip arthroplasty (THA). This study focuses on generating the information tool specifically for pain outcomes.Data from the Geneva Arthroplasty Registry (GAR) about patients receiving a primary elective THA between 1996 and 2019 was used. Selected outcomes were identified from patient and surgeon surveys: pain walking, climbing stairs, night pain, pain interference, and pain medication. Clusters of patients with homogeneous outcomes at 1, 5, and 10 years postoperatively were generated based on selected predictors evaluated preoperatively using conditional inference trees (CITs).Data from 6,836 THAs were analysed and 14 CITs generated with 17 predictors found significant (p < 0.05). Baseline WOMAC pain score, SF-12 self-rated health (SRH), number of comorbidities, SF-12 mental component score, and body mass index (BMI) were the most common predictors. Outcome levels varied markedly by clusters whilst predictors changed at different time points for the same outcome. For example, 79% of patients with good to excellent SRH and less than moderate preoperative night pain reported absence of night pain at 1 year after THA; in contrast, for those with fair/poor SHR this figure was 50%. Also, clusters of patients with homogeneous levels of night pain at 1 year were generated based on SRH, Charnley, WOMAC night and pain scores, whilst those at 10 years were based on BMI alone.The information tool generated under this study can provide prospective patients and clinicians with valuable and understandable information about the experiences of "patients like them" regarding their pain outcomes.

Authors & Co-authors:  Fabiano Cole Barea Cullati Agoritsas Gutacker Silman Hannouche Lübbeke Pinedo-Villanueva

Study Outcome 

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Statistics
Citations :  Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster J-Y. Health-related quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. JBJS. 2004;86(5):963–74.
Authors :  10
Identifiers
Doi : 10.1186/s12891-024-07357-6
SSN : 1471-2474
Study Population
Male,Female
Mesh Terms
Other Terms
Information tool;Pain management;Patient reported outcome measures;Shared decision making;Total hip arthroplasty
Study Design
Study Approach
Country of Study
Publication Country
England