Linking Joint-Specific Recovery to Overall Health Through Patient-Reported Outcome Measures: A Propensity-Score Matched Cohort Study in Total Joint Arthroplasty.

Background

Patient-reported outcome measures (PROMs) are increasingly used to evaluate disease-specific and overall health improvements following total hip and knee arthroplasty (THA/TKA). While disease-specific changes are well documented, the extent to which these procedures influence perceived overall health remains unclear. The aim of this study was to analyze changes in both disease-specific and overall health PROMs from the preoperative visit to one-year postoperatively in patients who underwent THA and TKA.

Methods

A retrospective cohort study was conducted using data from patients who underwent primary THA or TKA between 2016 and 2022 at a tertiary-care academic center and completed pre- and postoperative PROMs. Propensity score matching was applied to balance the two groups on demographic and clinical variables. Correlations were assessed between changes in Hip dysfunction and Knee injury Osteoarthritis Outcome Score for Joint Replacement (HOOS JR/KOOS JR) and Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-10) subscales (physical health, mental health, and quality of life [QOL]) using Pearson correlation (r) and Spearman's rank coefficients (⍴).

Results

Matched cohorts included 609 patients who underwent a THA procedure and 609 patients who underwent a TKA procedure. Changes in HOOS JR/KOOS JR were moderately to strongly correlated with physical health (THA: r = 0.63, 95% confidence interval [CI] = [0.58 to 0.68]; TKA: r = 0.56 [CI, 0.51 to 0.62]), but also weakly correlated with mental health (THA: r = 0.33 [CI, 0.26 to 0.40]; TKA: r = 0.24 [CI, 0.16 to 0.31]) and QOL (THA: ⍴ = 0.31 [CI, 0.24 to 0.38]; TKA: ⍴ = 0.22 [CI, 0.15 to 0.30]; all P-values for the correlations < 0.001). There were no statistically significant differences between the THA and TKA groups for the strength of correlations between joint-specific scores and physical health (P = 0.088), mental health (P = 0.103), and QOL (P = 0.101).

Conclusion

Findings from this study support the use of PROMs in evaluating THA and TKA surgical outcomes and emphasize the extent to which hip and knee health impacts patient-perceived overall health.