Can the pre-operative Western Ontario and McMaster score predict patient satisfaction following total hip arthroplasty?
- B. A. Rogers, MA, MSc, FRCS(Orth), Consultant Orthopaedic Surgeon and Honorary Senior Clinical Lecturer 1
; - B. Alolabi, MD, MSc, FRCSC, Orthopaedic Surgeon2;
- A. D. Carrothers, MB, ChB, FRCS(Orth), Consultant Orthopaedic Surgeon and Honorary Senior Clinical Tutor3;
- H. J. Kreder, MD, MPH, FRCS(C), Professor of Orthopaedic Surgery and Health Policy Evaluation and Management 4; and
- R. J. Jenkinson, MD, MSc, FRCSC , Assistant Professor of Orthopaedic Surgery 4
Abstract
In this study we evaluated whether pre-operative Western Ontario and McMaster Universities (WOMAC) osteoarthritis scores can predict satisfaction following total hip arthroplasty (THA). Prospective data for a cohort of patients undergoing THA from two large academic centres were collected, and pre-operative and one-year post-operative WOMAC scores and a 25-point satisfaction questionnaire were obtained for 446 patients. Satisfaction scores were dichotomised into either improvement or deterioration. Scatter plots and Spearman’s rank correlation coefficient were used to describe the association between pre-operative WOMAC and one-year post-operative WOMAC scores and patient satisfaction. Satisfaction was compared using receiver operating characteristic (ROC) analysis against pre-operative, post-operative and δ WOMAC scores.
We found no relationship between pre-operative WOMAC scores and one-year post-operative WOMAC or satisfaction scores, with Spearman’s rank correlation coefficients of 0.16 and –0.05, respectively. The ROC analysis showed areas under the curve (AUC) of 0.54 (pre-operative WOMAC), 0.67 (post-operative WOMAC) and 0.43 (δ WOMAC), respectively, for an improvement in satisfaction.
We conclude that the pre-operative WOMAC score does not predict the post-operative WOMAC score or patient satisfaction after THA, and that WOMAC scores can therefore not be used to prioritise patient care.
Cite this article: Bone Joint J 2015;97-B:150–3.
Footnotes
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The data collection was overseen by study personnel K. Milner and M. Kunz at Sunnybrook Health Sciences Centre (Toronto), and A. Thompson, J. Todd and K. Hrabok at London Health Sciences Centre (London, Ontario).
We would like to acknowledge the Safe T Investigators:
Principal Investigator:
Dr H. Kreder, Chief, Orthopaedic Surgery, Sunnybrook Health Sciences Centre.Co-investigators:
Dr J. Gollish, Medical Director, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre.
Dr G. Hawker, Physician-in-Chief, Department of Medicine, Women’s College Hospital.
Dr S. MacDonald, Orthopaedic Surgeon, London Health Sciences Centre.
Dr P. Corey, Associate Director Education, Dalla Lana School of Public Health, University of Toronto.
Dr M. Gignac, Senior Scientist, University Health Network, Toronto Western Research Institute, Health Care and Outcomes Research.
D. Kennedy, Manager, Hip and Knee Program Development, Holland Orthopaedic and Arthritic Centre, Sunnybrook Health Sciences Centre.
Dr R. Jenkinson, Orthopaedic Surgeon, Sunnybrook Health Sciences Centre.
Author contributions
B. A. Rogers: Data analysis, Preparing and editing manuscript.
B. Alolabi: Data analysis, Preparing and editing manuscript.
A. D. Carrothers: Data analysis, Preparing and editing manuscript.
H. J. Kreder: Study design, Funding application, Editing manuscript.
R. J. Jenkinson: Study design, Funding application, Editing manuscript.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by J. Scott and first proof edited by G. Scott.
- Received June 29, 2014.
- Accepted October 13, 2014.
