AB1317 WHAT IS A TOTAL KNEE OR TOTAL HIP ARTHROPLASTY FAILURE? A PATIENT PERSPECTIVE USING NOMINAL GROUPS. (June 2019)

• Record Type: Journal Article
• Authors: Singh, Jasvinder; Mehta, Bella; Mirza, Serene; Figgie, Mark; Sculco, Peter; Parks, Michael; Goodman, Susan
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 2121
• Page End: 2122
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.3064
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Total joint replacements (TJR) are commonly performed elective surgeries for people with end-stage arthritis. However, there is relative lack of qualitative research to define the patient perspective of what constitutes a failure of TJR Objectives: To discover when a TJR is considered a failure from the patients' perspective using nominal group technique (NGT). Methods: Patients who had undergone elective total hip (THR) and/or knee replacements (TKR) met in nominal groups to answer the question "When would you consider a knee or hip replacement to be a failure?". Patients competed questionnaires including demographics, pain, function, and satisfaction, independently listed their ideas and then ranked them with the group after clarification. Results: Six groups with 35 patients were held, all of whom had undergone THR and/or TKR between 2016 and 2018. Of these, 42% were male, 17% black (Table 1 ). Overall pain and function scores were high; Hip Disability and Osteoarthritis Outcome Score (HOOS) JR 95.3 (SD+/-11) and Knee Injury and Osteoarthritis Outcome Score (KOOS) JR 83.7 (SD+/-12.8) (range 0-100, higher score=less pain/functional limitation), and 86.1% were very/somewhat satisfied with their quality of life. The concerns ranked highest by the patients equating a TJR failure were A) refractory index joint pain (67 votes); B) unable to resume normal activities or go back to work (38 votes); C) minimal or no improvement in quality of life (24 votes); D) post-operative adverse events (40 votes); E) early revision surgery (32 votes); F) death (7 votes); G) expectation-outcome mismatch (1 vote); continuing secondary depression (1 vote) (Table 2 ). Conclusion: Poor results for pain, function, quality of life, or adverse events are the outcomes ranked highest by patients, defining TJR failure from the patients' perspective. Disclosure of Interests: jasvinder singh Shareholder of: Amarin pharmaceuticals and Viking therapeutics, Consultant for: Crealta/Horizon, Fidia, UBM LLC, Medscape, WebMD, the National Institutes of Health and the American College of Rheumatology, Bella Mehta: None declared, Serene Mirza: None declared, Mark Figgie: None declared, Peter Sculco: None declared, Michael Parks Grant/research support from: Zimmer Biomet, Employee of: Zimmer Biomet, Susan Goodman Grant/research support from: Novartis: research support, Consultant for: Novartis, UCB, Pfizer: consulting