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Symptoms of osteoarthritis influence mental and physical health differently before and after joint replacement surgery: A prospective study

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  • Thomas V Perneger
  • Didier Hannouche
  • Hermès H Miozzari
  • Anne Lübbeke

Abstract

Background: Patient-reported outcomes are increasingly used in evaluations of joint replacement surgery, but it is unclear if symptoms of osteoarthritis (i.e., pain and dysfunction) influence health perceptions similarly before and after surgery. Methods: In this prospective study based on a hospital-based arthroplasty registry, patients with primary total hip or knee arthroplasty (THA, N = 990, and TKA, N = 907) completed the WOMAC Pain and Function scales, and the SF12 Physical and Mental Component Scores (PCS and MCS), before surgery and one year later. Associations between WOMAC and SF12 scales were examined using mixed linear regression models. Results: All patient-reported outcomes improved following total joint arthroplasty, but the associations between symptom scales and global health perceptions were altered. Mental health scores at a given level of pain or function were lower after surgery than before, by about 4–5 points, a clinically meaningful and statistically significant difference. In contrast, the associations between WOMAC scales and the PCS remained stable. These findings were observed in both cohorts of patients. Conclusions: After total joint arthroplasty, mental health scores were lower than would have been expected given the symptomatic improvement. This suggests that relationships between patient-reported outcomes are context-dependent, and that care should be exerted when interpreting changes in patient-reported outcomes over time.

Suggested Citation

  • Thomas V Perneger & Didier Hannouche & Hermès H Miozzari & Anne Lübbeke, 2019. "Symptoms of osteoarthritis influence mental and physical health differently before and after joint replacement surgery: A prospective study," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0217912
    DOI: 10.1371/journal.pone.0217912
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    References listed on IDEAS

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    1. Lübbeke, A. & Silman, A.J. & Barea, C. & Prieto-Alhambra, D. & Carr, A.J., 2018. "Mapping existing hip and knee replacement registries in Europe," Health Policy, Elsevier, vol. 122(5), pages 548-557.
    2. Sprangers, Mirjam A. G. & Schwartz, Carolyn E., 1999. "Integrating response shift into health-related quality of life research: a theoretical model," Social Science & Medicine, Elsevier, vol. 48(11), pages 1507-1515, June.
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