title: Greater perceived helplessness in osteoarthritis predicts outcome of joint replacement surgery.
abstract: OBJECTIVE
  To determine if there is a difference between male and female patients in their perceived control of osteoarthritis (OA) symptoms at the time of joint replacement surgery, as measured by the Arthritis Helplessness Index (AHI), and how this helplessness affects surgical outcomes at 1 year.
  
  
  METHODS
  From a joint replacement registry, 70 male and 70 female patients were randomly selected and matched for age, body mass index, comorbidity, procedure, and education. Patients completed the AHI prior to surgery. Functional status was assessed at baseline and 1-year followup with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Linear regression modeling was used to determine the effect of sex on predicting AHI scores. A second model was constructed to examine the effect of AHI on the 1-year WOMAC change score.
  
  
  RESULTS
  There were no statistically significant differences in demographic data or clinically significant differences in AHI scores between sexes. Linear regression modeling showed that female sex was a significant predictor of a greater AHI score prior to surgery (p < 0.05). Moreover, a greater AHI score was an independent predictor of a lower WOMAC change score at 1 year (p = 0.01).
  
  
  CONCLUSIONS
  Interventions to improve control over arthritis symptoms should be studied with the goal of improving surgical outcomes.
authors.affiliation: Division of Orthopedic Surgery, University of Toronto, Toronto, Ontario, Canada. rajiv.gandhi@uhn.on.ca
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gandhi
authors.forename: Fahad
authors.initials: F
authors.lastname: Razak
authors.forename: Peggy
authors.initials: P
authors.lastname: Tso
authors.forename: J Roderick
authors.initials: JR
authors.lastname: Davey
authors.forename: Nizar N
authors.initials: NN
authors.lastname: Mahomed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012649:Self Concept; D012720:Severity of Illness Index; D012727:Sex Characteristics; D016896:Treatment Outcome