Orthopaedic & Rheumatologic Institute Outcomes
Total Hip Arthroplasty
Patient-Reported Outcome Measures 1 Year After Primary Unilateral Total Hip Arthroplasty for Osteoarthritis from the Prospective OME Cohort
2020-2021 (N = 2005, 69.8% follow-up)
In 2020, 31 distinct surgeons performed primary unilateral total hip arthroplasty (THA) surgery on 2005 patients with hip osteoarthritis (OA) at specific sites where the prospective Cleveland Clinic OME Cohort was active. Of these patients, 89.0% completed patient-reported outcome measures (PROMs) at baseline and 69.8% followed up at 1 year. The average patient age was 66.2 years and 42% were male.
96.7% of patients experienced improvement in hip pain after one year with a median absolute improvement of 52.5 points. Hip pain was measured by the Hip disability and Osteoarthritis Outcome Score¹ (HOOS) pain scale, which ranges from 0-100 points (higher scores indicate less hip pain) and has a minimal clinically important difference (MCID) of 10.0.
90.2% of patients experienced improvement in hip function with a median absolute improvement of 37.1 points. Hip function was measured by the Hip disability and Osteoarthritis Outcome Score Physical Function Shortform² (HOOS-PS) instrument, which ranges from 0-100 points (higher scores indicate better hip function) and has an MCID of 10.0.
83.2% of patients experienced improvement in overall physical health with a median absolute improvement of 17.8 points. Physical health was measured by the Veterans RAND 12-Item Health Survey³ (VR-12), which is a norm-based scale where 50 represents the mean score of a nonpatient control group and every 10 units represents 1 standard deviation from the mean. The MCID is estimated at 5.0.
The box plot illustrates patients' one-year outcomes with respect to three separate PROMs: hip pain, hip function, and overall physical health. Here, "improvement" means that the change in score from pre-op to post-op exceeds the MCID for a PROM and is represented by the shaded region around the horizontal axis. The center horizontal line of each box represents the median change in PROM score, while the boxed regions above and below the center line represent the middle 50% of patients. Error bars represent 95% of patients and circular bubbles represent outliers.
- Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS): validity and responsiveness in total hip replacement. BMC Musculoskelet Disord. 2003 May 30;4:10. doi: 10.1186/1471-2474-4-10. Epub 2003 May 30.
- Davis AM, Perruccio AV, Canizares M, Tennant A, Hawker GA, Conaghan PG, Roos EM, Jordan JM, Maillefert JF, Dougados M, Lohmander LS. The development of a short measure of physical function for hip OA HOOS-Physical Function Shortform (HOOS-PS): an OARSI/OMERACT initiative. Osteoarthritis Cartilage. 2008 May;16(5):551-9. doi: 10.1016/j.joca.2007.12.016. Epub 2008 Mar 4.
- Kazis LE, Miller DR, Skinner KM, Lee A, Ren XS, Clark JA, Rogers WH, Spiro A 3rd, Selim A, Linzer M, Payne SM, Mansell D, Fincke RG. Patient-reported measures of health: The Veterans Health Study. J Ambul Care Manage. 2004 Jan-Mar;27(1):70-83.