Are Patients Satisfied with their Total Joint Replacement Surgery? A Prospective Cross-sectional Survey.

Objective: The number of patients requiring arthroplasty increases annually. Joint replacement surgery can improve a patient's (QOL) quality of life. The effectiveness of this care from a patient's own perspective assessed by patient reported outcome measures is just as important as the clinical measures. The aim of our study was to evaluate patients' satisfaction following total joint replacement procedures.

Methods: A cross-sectional study was performed in a major regional hospital, (Port-of-Spain General Hospital, Trinidad). Between September 1(st) 2013 and December 31(st) 2014, Seventy-three patients were enrolled in the study. Two groups were created: a pre-operative group (with thirty-nine patients) and a post- operative group (of thirty-four patients). The postoperative group of patients received either total hip replacement or total knee replacement surgery from at least three months post procedure. The main outcome measures reported were: (i) orthopaedic patient reported outcome measures, oxford hip and knee scores. (ii) health related quality of life instrument, short form 12 (SF12) for mental and physical components of health gained (MCS and PCS). (iii) visual analogue scores to assess current pain. (iv). Patient's satisfaction levels with peri-operative management. (v) Fulfillment of patients' expectations with respect to pain, mobility and independence.

Results: The pre-operative group had a mean oxford hip score (OHS) score of 18.71, standard deviation (SD) 10.09. The postoperative group had a statistically significant higher level of functionality in terms of a mean Oxford hip score (OHS) 41.45, standard deviation (SD) 7.42. The pre-operative group had more disability (lower function) in terms of a mean oxford knee score (OKS) of 15.52, SD 7.10. The post- operative group's mean oxford knee score (OKS) was 37.27, SD 7.32.With respect to the short form 12 (SF12) quality of life assessment tool, the difference in mean PCS between groups was significant, pre op 28.57 (SD 7.52), post op 40.12.27 (SD 11.16). The difference in mean MCS between groups was also significant, pre op 48.76 (SD 9.02), post op 53.76 (SD 6.77). The difference in mean pain scores (VAS) between groups was significant, pre-op eight (SD 1.86), post-op 1.42 (SD 2.19). Postoperative patients were generally satisfied with their peri-operative management. Patient expectations were met in terms of pain, mobility and independence (92.31%, 94.87% and 94.87%, respectively).

Conclusion: Although multiple factors impact on patient satisfaction with respect to TJR surgery, statistically significant results showed increased function (improved Oxford scores), decreased pain (VAS) and general improvement in mental and physical health gained (SF12) between independent pre and post- operative groups. Clinically significant results indicate that postoperative patients were satisfied with peri-operative management and fulfillment of ex.