Patient Reported Outcome Measures (PROMs) after total hip- and knee replacement surgery evaluated by the Postoperative Recovery Profile questionnaire (PRP) – improving clinical quality and person-centeredness
Rationale and aims: The importance of evaluating postoperative recovery with consideration to the patient’s perspective has been emphasized. The aim of this study was to demonstrate how the recovery-specific Postoperative Recovery Profile (PRP) questionnaire can be used to evaluate patient-reported outcome measures (PROMs) after hip- and knee replacement in the enhancement of clinical quality and the person-centeredness of clinical services.
Method: Patients undergoing primary total knee- and hip replacement were eligible for this longitudinal follow-up study. The participants completed the PRP questionnaire on repeated occasions. In this paper, data from Day 3 and Month 1 after discharge were used. The change in recovery, between the two measurement occasions, on item-, dimensional- and global levels, both for each patient and for the group, were evaluated.
Results: A total number of 75 patients were included. One month after discharge the median PRP score was 13 (partly recovered) out of 19. Recovery changes towards lower levels of problems/difficulties were shown in both item-, dimensional- and global levels of recovery month 1 after discharge, as compared with Day 3. The group of patients was homogenous in change.
Conclusions: We demonstrated that the PRP questionnaire can be used to evaluate postoperative recovery after hip- and knee replacement surgery on item-, dimensional- and global levels. Data from each recovery level can be useful for quality development and in informing increases in the person-centeredness of clinical services. The global population scores can be used to evaluate treatment effect on a group of patients. It can also be used to define endpoints in follow-up studies.
Canadian Institute for Health Information, Canadian Joint Replacement Registry (CJRR). (2008). 2007 Annual Report—Hip and Knee Replacements in Canada. Ottawa: CIHI.
Husted, H., Holm, G. & Jacobsen, S. (2008). Predictors of length of stay and patient satisfaction after hip and knee replacement surgery. Fast-track experience in 712 patients. Acta Orthopaedica 79 (2) 168–173.
Lawlor, M., Humphreys, P., Morrow, E., Ogonda, L., Bennett D., Elliott, D. & Beverland, D. (2005). Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial. Clinical Rehabilitation 19, 465–474.
Montin, L., Leino-Kilpi, H., Suominen, T. & Lepistö, J. (2008). A systematic review of empirical studies between 1966 and 2005 of patient outcomes of total hip arthroplasty and related factors. Journal of Clinical Nursing 17, 40-45.
Rolfsson, O., Dahlberg, L. E., Nilsson, J-Å., Malchau, H. & Garellick, G. (2009). Variables determining outcome in total hip replacement surgery. Journal of Bone and Joint Surgery,(British Volume) 91 (2) 157-161.
Jansson, K.Å. & Granath, F. (2011). Health-related quality of life (EQ-5D) before and after orthopedic surgery. Acta Orthopaedica 82 (1) 82-89.
Jahromi, I., Walton, N.P., Dobson, P.J., Lewis, P.L. & Campbell, D.G. (2004). Patient-perceived outcome measures following unicompartmental knee arthroplasty with mini-incision. International Orthopaedics 28 (5) 286-289.
Learmont, I.D., Young, C. & Rorabeck, C. (2007). The operation of the century: total hip replacement. Lancet 307, 1508-1519.
Kärrholm, J. (2010). The Swedish Hip Arthroplasty Register (www.shpr.se). Acta Orthopaedica 81 (1) 3–4.
Knutson, K. & Robertsson, O. (2010). The Swedish Knee Arthroplasty Register (www.knee.se). The inside story. Acta Orthopaedica 81 (1) 5–7.
Allvin, R., Ehnfors, M., Rawal, N., Svensson, E. & Idvall, E. (2009). Development of a questionnaire to measure patient-reported postoperative recovery: content validity and intra-patient reliability. Journal of Evaluation in in Clinical Practice 15, 411-419.
Allvin, R., Svensson, E., Rawal, N., Ehnfors, M., Kling, A-M. & Idvall, E. (2011). The Postoperative Recovery profile (PRP) – a multi-dimensional questionnaire for evaluation of recovery profiles. Journal of Evaluation in in Clinical Practice 17 (2) 236-243.
Svensson, E. (1998). Ordinal invariant measures for individual and group changes in ordered categorical data. Statistics in Medicine 17 (24) 2923-2936.
Avdic, A. & Svensson, E. (2010). Svenssons method 1.1 ed. Örebro. Interactive software supporting Svenssons method. Accessed from http://www.oru.se/hh/Elisabeth_Svensson.
Svensson, E. & Starmark, J. E. (2002). Evaluation of individual and group changes in social outcome after aneurysmal subarachnoid haemorrhage: a long-term follow-up study. Journal of Rehabilitation Medicine 34 (6) 251-259.
Svensson, E, Schillberg, B., Kling, A-M. & Nyström. B. (2012). Reliability of the Balanced Inventory for Spinal Disorders, a questionnaire for evaluation of outcomes in patients with various spinal disorders. Journal of Spinal Disorders & Techniques 25 (4) 196-204.
Swedish Association of Local Authorities and Regions. (2011). http://www.kvalitetsregister.se/om_kvalitetsregister/quality_registries.
Salmon, P., Hall, G.M., Peerbhoy, D., Shenkin, A. & Parker, C. (2001) Recovery from hip and knee arthroplasty: Patients' perspective on pain, function, quality of life, and well-being up to 6 months postoperatively. Archives of Physical Medicine and Rehabilitation 82 (3) 360-366.
Jones, C.A., Beaupre, L.A., Johnston, D.W. & Suarez-Almazor, M.E. (2007). Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheumatic Disease Clinics of North America 33 (1) 71-86.
Gustafsson, B.A., Ponzer, S., Heikkila, K. & Ekman, S.L. (2007). The lived body and the perioperative period in replacement surgery; older people’s experiences. Journal of Advanced Nursing 60 (1) 20-28.
Vissers, M.M., de Groot, I.B., Reijman, M., Bussmann, J.B., Stam, H.J. & Verhaar, J.A. (2010). Functional capacity and actual daily activity do not contribute to patient satisfaction after total knee arthroplasty. BMC Musculoskeletal Disorders 11, 121 http://www.biomedcentral.com/1471-2474/11/121.
Kennedy, D.M., Stratford, P.W., Riddle, D.L., Hanna, S.E. & Gollish, J.D. (2008). Assessing recovery and establishing prognosis following total knee arthroplasty. Physical Therapy 88 (1) 22-32.
Nilsdotter, A.K., Toksvig-Larsen, S. & Roos, E.M. (2009). A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthritis and cartilage/OARS, Osteoarthritis Research Society 17 (5) 601-606.
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