2009 Annual Meeting Poster Presentations
Patient Expectations Regarding Activity Level Following Total Hip Resurfacing Arthroplasty
Poster Presentation Number: P064 Location: Venetian/Sands EXPO Hall DAdult Reconstruction Hip
Thorsten M Seyler, MD Winston-Salem NCJohn W Blackett
Mike S McGrath, MD Paterson NJ
Michael A Mont, MD Baltimore MD
David R Marker Baltimore MD
Patient expectations regarding sports activity following resurfacing are often not fully met due to associated pain and stiffness following surgery which negatively affects satisfaction.
Many resurfacing patients express interest in participating in sports activity following surgery. As increasing numbers of surgeons begin performing resurfacing surgeries, it is important to understand the expectations of these patients and to provide realistic recommendations. The questions asked in this study were: 1) What level of activity do patients expect 2) What level of activity do patients achieve?; 3) Does the level to which expectations are met correlate to satisfaction?; and 4) To what degree do poor pain and function inhibit activity levels?
Data was collected from a prospective cohort of 62 patients (69 hips) using pre- and post-operative questionnaires who had a minimum follow-up of 36 months. The patient mean age was 54 years (range, 25 to 78 years), and the mean BMI was 27.8 (range, 19 to 36). Pre- and post-surgery data included UCLA activity score, expected/ideal UCLA activity score, satisfaction (11-point scale), level that pain and stiffness inhibit activity (11-point scale; 0 = no inhibition and 10 = completely inhibits activity), and Harris Hip Score (HHS). Pre- and post-op assessments were compared using a Signed Rank test. The difference in expectations for UCLA activity score and actual UCLA activity score achieved was correlated to satisfaction using linear regression analysis and Pearson's coefficient.
Overall, the mean UCLA activity score increased from 4.6 (range, 1 to 8) to 7.4 (range, 1 to 10) (p<0.001). Despite this increase, the final UCLA activity scores were statistically lower (p <0.001) than the mean anticipated activity score reported by the patients prior to surgery at 9.1 (range, 5 to 10). There was a statistically significant correlation between low satisfaction levels and the points patients did not achieve in desired activity scores (R = 0.363, p = 0.002). Over half of the patients (n = 33, 53%) reported some level of pain and/or stiffness that interfered with their sports activity, and 39 patients (63%) did not reach their desired activity level. The correlation between HHS and the amount patients did not achieve in desired activity scores was also significant (R = 0.449, p = 0.0001).
The results of this study suggest that many patients have high expectations regarding sports activity following resurfacing. However, these expectations are often not fully met due to associated pain and stiffness following surgery which negatively affects patient satisfaction. Additional studies are being conducted to assess whether factors, such as commitment to rehabilitation or the use of a rehabilitation program altered from traditional standard total hip arthroplasties ones that is tailored specifically for young, high activity level resurfacing patients, may be important in helping patients reach their desired activity level or whether current expectations are unrealistic.
A · to the left of the title indicates the FDA has not cleared the drug or device for the described purpose.
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