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AB1317 WHAT IS A TOTAL KNEE OR TOTAL HIP ARTHROPLASTY FAILURE? A PATIENT PERSPECTIVE USING NOMINAL GROUPS

2019; BMJ; Linguagem: Inglês

10.1136/annrheumdis-2019-eular.3064

1468-2060

Jasvinder A. Singh, Bella Mehta, Serene Z. Mirza, Mark P. Figgie, Peter K. Sculco, Michael L. Parks, Susan M. Goodman,

Bone and Joint Diseases

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