Original Article
Outcome Assessment in the Elderly After Total Hip Arthroplasty

https://doi.org/10.1016/j.arth.2004.12.062Get rights and content

Abstract

An analysis of the Short-Form 36 (SF-36) and Oxford Hip questionnaires, were used to assess 2 randomized groups, by either mail or interview, at a minimum 10-year follow up after total hip arthroplasty. Ninety-nine patients (median age 77 years) were reviewed at a median 11 years after total hip arthroplasty. There was a 91% response rate to participation in the study. There was no significant difference between the groups for missing values. The mode of administration did not affect the mean Oxford scores (P > .1), but significant differences were noted in SF-36 health scales Role Emotional and Role Physical (P = .01). Analysis of other demographic variables revealed unexpectedly that comorbidity affected the Pain score in the Oxford questionnaire (P = .002) and that age had no effect on scores obtained in either questionnaire (P > .05). The uses of both general health and disease-specific questionnaires complement each other in the assessment of such groups. The SF-36 and Oxford questionnaires give a more accurate reflection of health status when self-completed while accepting higher missing values in an elderly population.

Section snippets

Materials and Methods

The data for this study were collected as part of a larger survey of patients after THA. Ninety-nine consecutive patients, who fulfilled the inclusion criteria, were invited to take part. Those who agreed were randomized to 1 of 2 groups. One group was allocated to receive both SF-36 and Oxford Hip questionnaires by post for completion, and the other group was allocated to have their questionnaires completed by interview. Patients were excluded if they had prior knowledge of either form, had a

Participation Rates

Consent rates were as follows: 9 (9%) refused to participate in the study. Of the 90 who took part 77 (85%) completed the questionnaires as per protocol for the randomized groups.

Of the 45 asked to self-complete the questionnaire by post, 3 were unable to do so, 2 were registered blind, and 1 had severe rheumatoid arthritis and was unable to write. These people were offered interview administration and all agreed.

Of the 45 who were assigned to the interview administration, 10 were unable to do

Discussion

The results of this study suggest that overall patient-based data on health outcome in the elderly population is reliable. The patients in this series were all older than 65 years, with 39% being more than 75 years. The response rate was 91%, with 85% of those completing the questionnaires in full. This was higher than previously reported studies of 71% and 82% response rates for SF-36 and 85% for Oxford questionnaire in the same age group 6, 23, 24. (There was crossover in our study, but this

Summary

The SF-36 and Oxford questionnaires are a reliable form of assessment in an elderly population after THA. The 2 questionnaires correlate well to pain and function, more so when the forms are self-administered, indicating their sensitivity and specificity to these outcomes. The Oxford Hip score is administered effectively to the elderly population when assessing THA with fewer missing values, consistency with either mode of administration, and better compliance than the SF-36, but may not truly

Acknowledgment

The authors thank P. Gibson for the support and opportunity to access his patients. They also thank Depuy International for the statistical support.

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    No benefits or funds were received in support of the study.

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