Assessing patients for joint replacement: can pre-operative Oxford hip and knee scores be used to predict patient satisfaction following joint replacement surgery and to guide patient selection?

A. Judge, N.K. Arden, A. Price, S. Glyn-Jones, D. Beard, A.J. Carr, J. Dawson, R. Fitzpatrick, R.E. Field

Research output: Contribution to journalArticle (Academic Journal)peer-review

60 Citations (Scopus)

Abstract

We obtained pre-operative and six-month post-operative Oxford hip (OHS) and knee scores (OKS) for 1523 patients who underwent total hip replacement and 1784 patients who underwent total knee replacement. They all also completed a six-month satisfaction question. Scatter plots showed no relationship between pre-operative Oxford scores and six-month satisfaction scores. Spearman's rank correlation coefficients were -0.04 (95% confidence interval (CI) -0.09 to 0.01) between OHS and satisfaction and 0.04 (95% CI -0.01 to 0.08) between OKS and satisfaction. A receiver operating characteristic (ROC) curve analysis was used to identify a cut-off point for the pre-operative OHS/OKS that identifies whether or not a patient is satisfied with surgery. We obtained an area under the ROC curve of 0.51 (95% CI 0.45 to 0.56) for hip replacement and 0.56 (95% CI 0.51 to 0.60) for knee replacement, indicating that pre-operative Oxford scores have no predictive accuracy in distinguishing satisfied from dissatisfied patients. In the NHS widespread attempts are being made to use patient-reported outcome measures (PROMs) data for the purpose of prioritising patients for surgery. Oxford hip and knee scores have no predictive accuracy in relation to post-operative patient satisfaction. This evidence does not support their current use in prioritising access to care.
Original languageEnglish
Pages (from-to)1660-1664
Number of pages5
JournalJournal of Bone and Joint Surgery
Volume93
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • Aged
  • Arthroplasty, Replacement, Hip
  • Arthroplasty, Replacement, Knee
  • Female
  • Health Status Indicators
  • Humans
  • Male
  • Outcome Assessment (Health Care)
  • Patient Satisfaction
  • Patient Selection
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • State Medicine
  • Surveys and Questionnaires
  • Treatment Outcome
  • United Kingdom

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