Greater perceived helplessness in osteoarthritis predicts outcome of joint replacement surgery.
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.
Gandhi
Rajiv
R
Division of Orthopedic Surgery, University of Toronto, Toronto, Ontario, Canada. rajiv.gandhi@uhn.on.ca
Razak
Fahad
F
Tso
Peggy
P
Davey
J Roderick
JR
Mahomed
Nizar N
NN
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