Patients’ perceptions shape joint replacement outcomes

In patients with osteoarthritis (OA) who undergo joint replacement surgery, a greater perceived lack of control of arthritis symptoms negatively affects 1-year outcomes. Measures aimed at improving a patient’s perceptions about OA may help improve outcomes.

Gandhi and coworkers performed a matched, retrospective analysis of patients (70 men and 70 women) undergoing unilateral primary hip or knee replacement surgery. They used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to assess patients’ functional status and pain level. The Arthritis Helplessness Index (AHI) was used to gauge perceptions of helplessness.

WOMAC scores were similar between men and women, before and after surgery. Preoperative AHI scores were also similar between men and women. However, relatively young women who had a high WOMAC score (indicating greater functional disability) had higher presurgical AHI scores, after adjusting for various factors (eg, body mass index, surgical procedure, and comorbidity). A higher AHI score also independently predicted less improvement on the WOMAC change score between baseline and 1 year postsurgery, after adjusting for the same variables.

The authors suggested that future work be directed toward understanding techniques for improving patients' ability to perceive control over their disease.