Hip Patients More Satisfied (or Forgetful) Than Knee Patients?

Interesting question.

A group of NYU Langone Health researchers decided to find out and they chose one specific measure of patient satisfaction, the Forgotten Joint Score, to measure assess the hip arthroplasty outcomes to knee arthroplasty outcomes.

The Forgotten Joint Scores, by the way, are based on a novel construct: the patient’s ability to forget about a joint as a result of successful treatment.

“Surgeons often judge the success of an operation on joint alignment and stability, but patients evaluate outcomes in terms of vitality and ability to return to their leisure activities,” explained the study’s authors.

To get an answer, the research team culled data from 2,359 individuals who had surgery between September 2016 and September 2019 and who had completed the Forgotten Joint Score-12 questionnaire at one of three time periods (3, 12, and 21 months) postoperatively. Samples questions included, “Are you aware of your artificial hip/knee in bed at night? When you are squatting? When you are climbing stairs.”

Co-author Ran Schwarzkopf, M.D. associate professor in the Department of Orthopedic Surgery at NYU Langone Health in New York City, explained the objectives of the study to OTW, “We wanted to examine the differences between THA [total hip arthroplasty] patients and TKA [total knee arthroplasty] patients in regard to the patient’s perception of their artificial joint. The Forgotten Joint Score is a validated outcome measure that helps us understand the patient’s perception and satisfaction from their artificial joint. We know that for 10-15% of TKA patients we fail to meet their expectation after TKA. This fact motivated us to compare the Forgotten Joint Score outcomes between THA and TKA and to try to understand the differences between the two patient populations.”

“Among the most interesting findings were the expected differences between the THA and TKA cohorts. We hypothesized that THA patients had higher Forgotten Joint Scores compared to TKA in all time points. We also observed that patients undergoing TKA tend to be older, have a higher BMI [body mass index], and have more comorbidities in comparison to THA patients.”

And with a tip of the hat to the elderly set, he added, “Especially interesting was that in both cohorts, THA and TKA, older patients had higher Forgotten Joint Scores.”

“The work helps us better understand how patients perceive their total joint replacement during and after recovery. We are able to anticipate their improvement over the first year, and we understand that our older patients do better than our younger ones and that THA patients do better than TKA patients.”

“As surgeons we need to improve and try to better match our TKA patients’ expectations. In my practice I try and explain to my patients what to expect after surgery and to make sure their goals are achievable and that they will be satisfied from their recovery and ultimate activity level.”