title: Patterns of recovery following knee and hip replacement in an Australian cohort.
abstract: Most literature reporting the impressive results from knee and hip replacement derives from international data. Few Australian studies have comprehensively compared outcomes after joint replacement up to 1 year. This paper compares the patterns of recovery across physical and patient-centred outcomes following knee or hip replacement in an Australian cohort. One hundred and twenty-two consecutive patients undergoing knee or hip replacement were prospectively followed. Serial assessments were conducted (preoperatively, and 2, 6, 12, 26 and 52 weeks post-surgery). Joint pain, patient's global improvement, timed mobility, and complications were monitored. English-proficient patients completed WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and SF-36v2 (Medical Outcomes Short-Form 36 version 2) questionnaires. At 1 year, 81% (55 knee, 44 hip) were available for follow-up. Significant, large improvements (up to 254%) were evident for most outcomes. Global improvement was reported by 97%. Recovery for both surgical groups was greatest within the first 26 weeks, but hip patients improved more quickly in most outcomes. Wound disturbances were the most common complication (23 in total, 23%) and 13 patients (13%) were readmitted for complications. Recovery patterns were similar to that observed elsewhere. The physical and patient-centred outcomes provide a useful Australian reference for clinicians of the temporal aspects of recovery as well the differences between hip and knee surgeries. Complication and readmission rates appeared high, possibly partly explained by the rigorous capture method.
authors.affiliation: Whitlam Joint Replacement Centre, UNSW SWS Clinical School, Fairfield Hospital, Sydney, NSW, Australia. Justine.Naylor@sswahs.nsw.gov.au
authors.forename: Justine M
authors.initials: JM
authors.lastname: Naylor
authors.forename: Alison R
authors.initials: AR
authors.lastname: Harmer
authors.forename: Robert C
authors.initials: RC
authors.lastname: Heard
authors.forename: Ian A
authors.initials: IA
authors.lastname: Harris
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D001315:Australia; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care