Assessment of a Satisfaction Measure for Use After Primary Total Joint Arthroplasty

Background
Patient satisfaction after total hip (THA) and total knee arthroplasty (TKA) is a core outcome selected by the Outcomes Measurement in Rheumatology. Up to 20% of THA/TKA patients are dissatisfied. Improving patient satisfaction is hindered by the lack of a validated measurement tool that can accurately measure change.

Methods
The psychometric properties of a proposed satisfaction instrument, consisting of 4 questions rated on a Likert scale, scored 1-100, were tested for validity, reliability, and sensitivity to change using data collected between 2007 and 2011 in an arthroplasty registry.

Results
We demonstrated construct validity by confirming our hypothesis; satisfaction correlated with similar constructs. Satisfaction correlated moderately with pain relief (TKA ? = 0.61, THA ? = 0.47) and function (TKA ? = 0.65, THA ? = 0.51) at 2 years; there was no correlation with baseline/preoperative pain/function values, as expected. Overall Cronbach’s alpha >0.88 confirmed internal consistency. Test-retest reliability with weighted kappa ranged 0.60-0.75 for TKA and 0.36-0.56 for THA. Hip disability and Osteoarthritis Outcome Score/Knee injury and Osteoarthritis Outcome Scores quality of life improvement (>30 points) corresponds to a mean satisfaction score of 93.2 (standard deviation, 11.5) after THA and 90.4 (standard deviation, 13.8) after TKA, and increasing relief of pain and functional improvement increased the strength of their association with satisfaction. The satisfaction measure has no copyright and is available free of cost and represents minimal responder burden.

Conclusion
Patient satisfaction with THA/TKA can be measured with a validated 4-item questionnaire. This satisfaction measure can be included in a total joint arthroplasty core measurement set for total joint arthroplasty trials.

Contributors

Susan M. Goodman, Bella Y. Mehta, Cynthia A. Kahlenberg, Ethan C. Krell, Joseph Nguyen, Jackie Finik, Mark P. Figgie, Michael L. Parks. Douglas E. Padgett, Vinicius C. Antao, Adolph J. Yates, Bryan D. Springer, Steven L. Lyman, Jasvinder A. Singh

Publication

Journal: The Journal of Arthroplasty
Volume: 35
Issue: 7
Pages: 1792 - 1799
Year: 2020
DOI: 10.1016/j.arth.2020.02.039

Further Study Information

Current Stage: Completed
Date:
Funding source(s):

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Method(s)

Linked Studies

• Achieving Consensus on Total Joint Replacement Trial Outcome Reporting Using the OMERACT Filter: Endorsement of the Final Core Domain Set for Total Hip and Total Knee Replacement Trials for Endstage Arthritis
• Outcome Domains and Measures in Total Joint Replacement Clinical Trials: Can We Harmonize Them? An OMERACT Collaborative Initiative
• Consensus on draft OMERACT core domains for clinical trials of Total Joint Replacement outcome by orthopaedic surgeons: a report from the International consensus on outcome measures in TJR trials (I-COMiTT) group
• Patients and surgeons provide endorsement of core domains for total joint replacement clinical trials
• Do outcomes reported in randomised controlled trials of joint replacement surgery fulfil the OMERACT 2.0 Filter? A review of the 2008 and 2013 literature

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