Abstract:

Introduction: Evaluating outcomes following total hip arthroplasty (THA) has been essential for improving satisfaction and quality of care. However, finding systems that fully encompass these outcomes poses a challenge for physicians, and often still do not provide an adequate picture of a patient’s recovery. Therefore, we evaluated different scoring systems to determine the most efficient method of assessing the outcomes of patients undergoing THA.
Materials and Methods: We evaluated all hip scoring systems currently available in the literature and identified the parameters assessed in the questionnaires. The parameters were then subdivided into subjective, objective, rehabilitative, and quality of life outcome measures. We identified the most commonly referenced questionnaires and assessed multiple permutations of these with other scoring systems to determine the combinations that would most efficiently and comprehensively evaluate the outcomes of patients undergoing THA.
Results: The 42 identified scoring systems covered the following parameters: 4 subjective, 5 objective, 17 rehabilitative, and 18 quality of life. The Harris Hip Score (HHS) was the most cited system (5,613), but the Hip Disability and Osteoarthritis Outcome Score (HOOS) had the greatest coverage of all the parameters (49%). On combinatorial analysis, the 2-, 3-, and 4-item permutations that had the greatest coverage were HOOS and 36-Item Short-Form Health Survey (SF-36) (59%), HOOS, SF-36, and Larson (75%), and HOOS, SF-36, Larson, and Lower Extremity Functional Scale (LEFS) (80%).
Conclusion: Physicians and researchers have attempted to fully assess the outcomes of patients undergoing THA. Utilizing existing scoring systems in particular combinations may allow us to form an ideal questionnaire that provides sufficient coverage of parameters, thus providing a more comprehensive way to cost-effectively evaluate outcomes. Further analysis is required to determine whether or not these permutations provide a sufficient evaluation in a clinical setting.

Authors:

Jaydev B. Mistry, MD, Research Fellow, Julio J. Jauregui, MD, Research Fellow, Aaron L. Lerner, BS, Research Volunteer, Morad Chughtai, MD, Research Fellow, Randa K. Elmallah, MD, Research Fellow, Michael A Mont, MD, Director, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland

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