Assessment of a Satisfaction Measure for Use After Primary Total Joint Arthroplasty |
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| Institution: | 1. Hospital for Special Surgery, Department of Rheumatology, New York, NY;2. Hospital for Special Surgery, Department of Orthopedics, New York, NY;3. Hospital for Special Surgery, Department of Biostatistics, New York, NY;4. Memorial Sloan Kettering Cancer Center, New York, NY;5. Hospital for Special Surgery, Department of Value Management, New York, NY;6. Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA;7. OrthoCarolina Hip and Knee Center, Charlotte, NC;8. The University of Alabama at Birmingham Medical Center, Birmingham, AL;1. Division of Nursing, Saga University, Saga, Japan;2. Department of Health Science, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan;3. Department of Nursing, School of Nursing and Rehabilitation, Konan Women''s University, Kobe, Hyogo, Japan;4. Department of Orthopedic Surgery, Saga University, Saga, Japan;1. Department of Surgery, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada;2. Department of Surgery, University of Calgary, Calgary, Alberta, Canada;3. Alberta Hip and Knee Clinic, Calgary, Alberta, Canada;4. Alberta Bone and Joint Health Institute, Calgary, Alberta, Canada;5. McCaig Institute for Bone and Joint Health, Calgary, Alberta, Canada;1. Harris Orthopaedic Laboratory, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA;2. Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA;3. Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood, CA;4. Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark |
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| Abstract: | BackgroundPatient satisfaction after total hip (THA) and total knee arthroplasty (TKA) is a core outcome selected by the Outcomes Measurement in Rheumatology. Up to 20% of THA/TKA patients are dissatisfied. Improving patient satisfaction is hindered by the lack of a validated measurement tool that can accurately measure change.MethodsThe psychometric properties of a proposed satisfaction instrument, consisting of 4 questions rated on a Likert scale, scored 1-100, were tested for validity, reliability, and sensitivity to change using data collected between 2007 and 2011 in an arthroplasty registry.ResultsWe demonstrated construct validity by confirming our hypothesis; satisfaction correlated with similar constructs. Satisfaction correlated moderately with pain relief (TKA ρ = 0.61, THA ρ = 0.47) and function (TKA ρ = 0.65, THA ρ = 0.51) at 2 years; there was no correlation with baseline/preoperative pain/function values, as expected. Overall Cronbach’s alpha >0.88 confirmed internal consistency. Test-retest reliability with weighted kappa ranged 0.60-0.75 for TKA and 0.36-0.56 for THA. Hip disability and Osteoarthritis Outcome Score/Knee injury and Osteoarthritis Outcome Scores quality of life improvement (>30 points) corresponds to a mean satisfaction score of 93.2 (standard deviation, 11.5) after THA and 90.4 (standard deviation, 13.8) after TKA, and increasing relief of pain and functional improvement increased the strength of their association with satisfaction. The satisfaction measure has no copyright and is available free of cost and represents minimal responder burden.ConclusionPatient satisfaction with THA/TKA can be measured with a validated 4-item questionnaire. This satisfaction measure can be included in a total joint arthroplasty core measurement set for total joint arthroplasty trials. |
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| Keywords: | total hip arthroplasty total knee arthroplasty PROMs satisfaction survey validation total joint arthroplasty |
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