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SIGNIFICANCE OF THE QUALITY OF LIFE ASSESSMENT QUESTIONNAIRES SF-36 AND WOMAC IN LONG TERM STUDIES AFTER TOTAL HIP ARTHROPLASTY

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Background: There are many clinical and radiographic long term results of Total Hip Arthroplasties reported in literature but very few attend to the subjective quality of life of patients living with an implant. In the last few years different quality of life assessment scores were developed. In this study the subjective SF-36 and the WOMAC score were evaluated and the results were compared to the commonly used clinical Harris Hip Score.

Patients and methods: From a total number of 152 cement-less Total Hip Arthroplasties (Alloclassic®) performed between October 1987 and December 1988 at our clinic, 103 hips in 99 patients were available for a clinical and radiographic evaluation with an average follow-up of 14.3 years. For clinical evaluation the Harris Hip Score was used. Additionally all patients got SF-36 and WOMAC questionnaires. 78 questionnaires were returned fully completed and could be evaluated. The overall results and the results in the domain “pain” and “function” which occur in all three scores were compared statistically.

Results: The mean Harris Hip Score was 88.2 (range 24 – 100), pain score 41.9 and function score 48.4. The mean WOMAC Score was 10.6 in total, pain 2.8 and function 3.9. The SF-36 domain “Bodily Pain” was 56.6 and “physical function” 48.2. Concerning the domain “function” a significant correlation was found in all of the three scores (p < 0.01). A significant “pain” correlation was seen comparing the SF-36 to the WOMAC score (p < 0.01). No significant correlation was found comparing the clinical Harris Pain Score to the SF-36 domain “Bodily Pain” and to the WOMAC pain score.

Conclusion: In this study the subjective assessment questionnaires SF-36 and WOMAC show significant similar results to the clinical Harris Hip Score concerning the domain “function”. Concerning “Pain” comparable results were found between the SF-36 and the WOMAC with no significant correlation to the HHS. These data suggest that the quality of life assessment questionnaires can not replace the clinical evaluation using a clinical score.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.