title: The SF-36 general health status survey documents the burden of osteoarthritis and the benefits of total joint arthroplasty: but why should we use it?
abstract: OBJECTIVE
  To document the disease burden of osteoarthritis and the benefits of total joint replacement by using the Short Form Health Survey (SF-36) general health status survey and evaluate other factors that could affect scores.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  All patients scheduled for primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) (n = 622 preoperatively) in 2 years were surveyed using the SF-36, which assesses health-related quality of life (HRQOL) in patients' physical and social functioning and mental health. Follow-up surveys were administered 12 months after surgery to all patients and 3 and 24 months after surgery to a subset of patients.
  
  
  RESULTS
  Preoperatively, patient scores were significantly lower than normative scores in the physical functioning, bodily pain, and social functioning domains. Preoperative scores were not different between THA and TKA patients. Women scored lower than men. Comorbid conditions were weakly associated with low SF-36 scores. Postoperatively, the largest incremental improvement in scores was seen at 3-month follow-up. Scores improved sooner and more substantially in THA vs TKA patients and in men vs women, paralleling improvement in clinical and subjective ratings of postoperative physical function and pain.
  
  
  CONCLUSIONS
  The SF-36 has the sensitivity to document improvement in HRQOL after surgery and to reveal differences in THA vs TKA and in men vs women. However, routine use of outcome assessment instruments to monitor this patient population is costly and unjustified in our current healthcare environment.
authors.affiliation: Miller Orthopaedic Clinic, Charlotte, NC, USA. gkiebzak@sleh.com
authors.forename: Gary M
authors.initials: GM
authors.lastname: Kiebzak
authors.forename: Meredith
authors.initials: M
authors.lastname: Campbell
authors.forename: David R
authors.initials: DR
authors.lastname: Mauerhan
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000534:rehabilitation*; D017281:Cost of Illness; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010003:Osteoarthritis / Q000534:rehabilitation / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile