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UBC Theses and Dissertations

Outcomes evaluation in knee arthroplasty for the treatment of osteoarthritis Sweeney, Mary Kathleen


Objectives: The primary objective was to evaluate differences in outcome between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) with respect to total WOMAC and OKS scores. In order to properly evaluate outcomes following both UKA and TKA valid and responsive instruments are needed. Therefore the second objective was to assess the construct validity and responsiveness of the SF-6D and the WOMAC derived HUI3 in patients undergoing either UKA or TKA. Lastly, the third objective was to evaluate any differences in the effect of socioeconomic status in outcomes following UKA compared to TKA. Methods: A retrospective analysis was conducted to evaluate outcomes following knee arthroplasty on data collected between July 2000 and December 2008 on all patients requiring either UKA or TKA. Patients completed the WOMAC, OKS and SF-12 preoperatively and then subsequently at 3 and 6 months post-surgery. The Pearson correlation coefficient and intraclass correlation coefficient (ICC) were used to measure the correlation between the OKS, WOMAC, SF-6D and HUI3. Responsiveness was evaluated using a distribution based evaluation and an anchor-based method. A three level hierarchical linear model was used to model the total WOMAC scores and OKS as a function of group (UKA or TKA) and time. A similar model was used to investigate whether differences in total WOMAC or OKS between UKA and TKA occur across socioeconomic groups. Results: The WOMAC derived HUI3 and SF-6D appear to be valid measures of HRQL in this patient sample. The SF-6D was not as responsive as the HUI3 but demonstrated a good ability to identify patients who had improved. There were no significant differences in HRQL between UKA and TKA and socioeconomic status did not have a significant effect on HRQL following knee arthroplasty. Conclusions: Both the HUI3 and SF-6D appeared to be valid and responsive measures in this patient sample. However, further study looking at the interchangeability of the WOMAC derived HUI3 with the HUI3 itself is needed. No differences in HRQL between UKA and TKA were noted and there were no differences in outcome between UKA and TKA across SES groups.

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Attribution 3.0 Unported