title: Patient-reported quality of life after primary major joint arthroplasty: a prospective comparison of hip and knee arthroplasty.
abstract: BACKGROUND
  To investigate and compare the impact of primary hip (THA) and knee (TKA) arthroplasty on quality of life in patients with osteoarthritis, to determine patients' satisfaction with total joint arthroplasty, and to detect the effect of patients' demographic and clinical characteristics on outcome.
  
  
  METHODS
  Three hundred seventy eight (378) patients with hip (174) and knee (204) osteoarthritis undergoing total joint arthroplasty (174 THA-204 TKA) were assessed pre- and post-operatively (6 weeks, 3, 6, and 12 months) using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and Centre for Epidemiological Studies Depression Scale (CES-D10). The patients' satisfaction with the results of total joint arthroplasty was also assessed. Differences were analyzed using general linear model for repeated measures.
  
  
  RESULTS
  The one-year response rate was 97 % for THA and 90 % for TKA. WOMAC and CES-D10 scores improved significantly after one year for both THA and TKA (P < 0.0001). The improvement in WOMAC total score was significantly greater for TKA patients (P < 0.0001 at 12 months). WOMAC pain and stiffness improved earlier for THA (6 weeks), while TKA had equivalent improvements at 3 and 6 months respectively. Both THA/TKA displayed significant improvement of WOMAC function at 3 months but TKA had greater improvement. Age, body mass index, residence, education and social support were not significant predictors of quality of life after total joint arthroplasty. One year postoperatively 88 % of patients were satisfied.
  
  
  CONCLUSIONS
  WOMAC and CES-D10 improved significantly one year postoperatively. Although pain and stiffness improved earlier in THA, functional improvement was inferior in THA compared to TKA.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, 3 Panepistimiou Street Βiopolis, 41500, Larissa, Greece. dailiana@med.uth.gr.
authors.forename: Zoe H
authors.initials: ZH
authors.lastname: Dailiana
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, 3 Panepistimiou Street Βiopolis, 41500, Larissa, Greece. pappolly@yahoo.gr.
authors.forename: Ippolyti
authors.initials: I
authors.lastname: Papakostidou
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, 3 Panepistimiou Street Βiopolis, 41500, Larissa, Greece. svaritimidis@ortho-uth.org.
authors.forename: Sokratis
authors.initials: S
authors.lastname: Varitimidis
authors.affiliation: Center for Health Services Management and Evaluation, Faculty of Nursing, University of Athens, Athens, Greece. lliaropo@nurs.uoa.gr.
authors.forename: Lycurgos
authors.initials: L
authors.lastname: Liaropoulos
authors.affiliation: Department of Biomathematics, Faculty of Medicine, School of Health Sciences, University of Thessalia, 3 Panepistimiou Street, Βiopolis, 41500, Larissa, Greece. zintza@med.uth.gr.
authors.forename: Elias
authors.initials: E
authors.lastname: Zintzaras
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, 3 Panepistimiou Street Βiopolis, 41500, Larissa, Greece. kar@med.uth.gr.
authors.forename: Theofilos
authors.initials: T
authors.lastname: Karachalios
authors.affiliation: Department of Orthopedics, NIMITS Hospital, 10 Monis Petraki Street, Athens, Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Michelinakis
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessalia, 3 Panepistimiou Street Βiopolis, 41500, Larissa, Greece. malizos@med.uth.gr.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Malizos
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology* / Q000639:trends; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D016896:Treatment Outcome