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CASE REPORT

Investigation of Expectations of Patients Having Undergone Total Hip Arthroplasty in Our Society

Nuray ELIBOL1, Bayram UNVER2, Vasfi KARATOSUN3*

1 Department of Physiotherapy and Rehabilitation, School of Health, Izmir University, Izmir, 35350, Turkey.

2 Department of Orthopedic Physiotherapy, School of Physiotherapy, Dokuz Eylül University, Izmir, 35340, Turkey.

3 Department of Orthopedics, School of Medicine, Dokuz Eylül University, Izmir, 35340, Turkey.

 

Address for Correspondence

Nuray ELIBOL, PhD, PT Izmir University, School of Health,

Department of Physiotherapy and Rehabilitation,

TR-35350, Uckuyular-Izmir-TURKEYTel: +90 232 2464949, Fax: +90 232 2240909,

E-mail: nuray.elibol@izmir.edu.tr

 

Abstract:

Purpose: Patients’ expectations from orthopedic treatment may vary depending on their age, sex, diagnosis, lifestyle and cultural habits. Therefore, there is a need for information regarding lifestyle and cultural habits specific to communities. The purpose of this study is to determine and evaluate the expectations of patients with total hip arthroplasty in our society.

Methods: The study included 94 (35 male and 59 female) patients with primary total hip prosthesis. The patients’ mean age was 57.1 ± 14.6. They were all operated by the same surgeon. Patients were evaluated with the 15-item total hip arthroplasty clinical evaluation questionnaire, 25-item expectation questionnaire and Harris Hip Score.

Results: While the improvement in walking ability was the most important expectation stated by the patients (97.9%), the possibility to work again was the least important one (12.8%). While the reduction in pain after the operation was the parameter satisfying the patients most (98.9%), patients' activity level during the last 3 months was the parameter satisfying the patients least (72.3%).

Conclusion: In our study, we determined that the most important expectations of the patients in our society were the restoration of functions and pain relief. The parameters the patients were satisfied with least were activity and working levels, and the ability to climb up and down the stairs. Determining patients’ expectations and their improvement rates makes it possible to create problem-specific treatment programs. It was concluded that this information would help those planning and implementing the treatment to determine the methods and targets of the treatment.

 

J.Orthopaedics 2012;9(4)e8

Keywords:

Total hip replacement; lifestyle; culture; patient expectations 



Introduction:

Total hip arthroplasty (THA) is one of the most commonly performed types of endoprosthesis in the body, and patients having undergone THA are the patients to whom physiotherapists provide therapy most frequently (1). It has been determined that patients have high expectations from THA in terms of both physical and psychological improvement (2,3).

In several studies, it has been reported that orthopedic patients' expectations and goals may vary depending on their treatment, age, gender, diagnosis, lifestyle and cultural habits (4,5). Thus, information regarding lifestyles and cultural habits specific to communities is needed (4,5). Assessment of patients’ expectations is necessary for several reasons: being aware of patients’ expectations helps the clinician to know what to focus on, improves the patient's education level, allows health professionals to reach a joint decision if there are different treatment options, increases the chances to implement recommendations regarding the treatment of the patient and plays a decisive role in the evaluation of treatment outcomes of the patient (2,3,6,7).

In addition, these manageable expectations affect patient satisfaction (7). In case patient satisfaction is not known, patients may receive either poor or superfluous rehabilitation, which affects the costs of treatment and the efficient use of rehabilitation resources (7).

Arthroplasty is a costly and elective surgical procedure. Patients’ views are of importance in the assessment of the success of an arthroplasty application (8). In the literature, there are a limited number of studies investigating the expectations of patients (2,3,6,7,9,10). In our society, only one study was conducted on the expectations of patients having undergone total knee replacement (7). However, expectations of patients who underwent THA were not investigated at all. The aim of this study was to determine and evaluate expectations of patients having undergone THA.

 

Material and Methods :

Patients who underwent elective THA performed by the same surgeon at least 6 months before were telephoned and requested to participate in the study. Ninety-four of them (35 male, 59 female) accepted to take part in the study. Their mean age was 57.1 ± 14.6 years. The patients were classified in terms of gender (male and female), age (those over 65 years of age and those under 65 years of age) and body mass index (BMI) (those over 30 kg / m² and those under 30 kg / m²).

Evaluation forms used in the study were filled in by the physiotherapist and patients together through face to face interviews. Those who had revision for THA, who had a total knee arthroplasty due to fractures, who had a systemic disease (chronic heart failure and chronic obstructive pulmonary disease) which might seriously affect their functions, who had neurological problems affecting their locomotor system, and who were diagnosed with a sleep disorder were excluded from the study. Those patients who agreed to participate in the study voluntarily were given a detailed description about the evaluation to be made and their written approvals were received. The approval for the study was received from the Ethics Committee of Dokuz Eylül University Faculty of Medicine (Appendix 1).

In the study, demographic data of the patients (education level, employment status, income level, the moral condition, marital status, residential living, with whom he/she lived), activities (performing salat-one of the pillars of Islam performed five times a day-, squatting) and their living areas (the toilet type they used and the dining area) were evaluated. In the study, the modified 15-item THA clinical evaluation questionnaire (10 items about clinical parameters and 5 items about patient satisfaction parameters) (3,9) and the modified Hospital for Special Surgery Hip Replacement Expectations Survey were used (3,9,11).

The results of the clinical parameters were classified as follows: the scores 1 (poor), 2 (weak) and 3 (moderate) meant “not satisfied” and the scores 4 (strong) and 5 (excellent) meant “satisfied”. Expectation Survey results were classified as follows: the scores 1 (very important) and 2 (quite important) meant “important” and the scores 3 (moderately important), 4 (somewhat important) and 5 (not important) meant “not important”.

In addition, Harris Hip Scoring was used to determine the hip functions of the patients (12). The patients were divided into two groups according to the scores they obtained from Harris Hip Scores: those receiving 90-100 were good; those receiving = 89 were poor. For the statistical analysis of the data, Statistical Package for Social Science for Windows (SPSS) version 15.0 was used. The data were given as mean, standard deviation, frequency and percentage.

 

 

Results :

Socio-demographic features of the patients are shown in Table 1. The patients’ mean Harris Hip Scores for the right and left hips were 92.7 ± 1.6 and 93.2 ± 8.8 respectively (Table 1). When the patients’ expectations were ranked according to the rate of importance, improvement of walking ability was regarded as the most important expectation (97.9%) whereas the possibility to work in a job again was regarded as the least important expectation (12.8%) (Table 2).

According to the results of clinical parameters, the parameter the patients were satisfied with the most was that operation reduced the medical needs to relieve pain (98.9%) whereas the parameter the patients were satisfied with the least was the levels of activity and work during the last three months (72.3%) (Table 3). When the patients were divided into 2 groups in terms of their age (over age 65 and under age 65), there was a significant difference between the two groups regarding the following parameters: relieve nighttime pain, improve sexual activity, eliminate need for medications, improvement to use public transport or private vehicles (p <0.05). These parameters were more important for patients younger than 65 years of age (Table 4).

When the patients were divided into 2 groups in terms of their gender (male and female), there was a significant difference between the two groups regarding the following parameters. As improvement of performing daily activities around home was more important for females improvement of performing daily activities away from home was more important for males. Improvement ability to squat and having possibility to work in a job again were more important for males than females (Table 5). When the patients were divided into 2 groups in terms of their body mass index (BMI) (those over 30 kg / m² and those under 30 kg / m²),

there was a significant difference between the two groups regarding the following parameters: relieve day time pain, improvement to use public transport or private vehicles, eliminate need for medications and improve sexual activity (p <0.05). This expectation was considered more important by patients with BMI under 30 kg / m² (Table 6).

The patients were divided into 2 groups according to Harris Hip Scores: the scores between 90 and 100 points were considered good and the scores 89 or less were considered poor. There was a significant difference between the two groups in terms of expectations regarding the improvement of climbing up and down stairs,remove need for cane or assistive device, relieve daytime pain and eliminate need for medications (p <0.05). These expectations were of more importance for the patients with higher Harris Hip Scores (Table 7).

 

Discussion:

In elective procedures such as total joint arthroplasty, it is very important to keep in mind the results of treatment and the expectations of patients while the results of orthopedic surgeries are determined (3,7). That is because THA is a procedure performed to improve the quality of life (8,10). Why patients prefer arthroplasty for the treatment and what their expectations from the intervention are play a critical role (3). Unknown expectations or unsuccessful arthroplasty often leads to personal limitations (7). Therefore, it is recommended to evaluate patients’ expectations and views in detail. In our study, we investigated expectations and satisfaction of patients having undergone elective THA, and the results revealed that the highest expectations from THA were as follows: improvement in the ability to walk (97.9%), improvement in the ability to climb up and down the stairs (96.8%), improvement in the ability to perform daily activities (95.7%), while the lowest expectations from THA were as follows: to be able to work again (43.6%), improvement in sexual activity (36.2%) and improvement in the ability to exercise or play sports (12.8%) (Table 2).

The parameters the patients were most satisfied with after the operation were reduction in the medical needs to relieve pain (98.9%), reduction in pain (97.9%) and an increase in the ability to rise from the sitting position to standing position (92.6%) whereas the parameters the patients were least satisfied with were the levels of activity and work (73.4%), the ability to walk up and down the stairs (73.4%) and the levels of activity and work during the last three months (72.3%) (Table 3). Our study included 94 patients having undergone THA at least 6 months before. By six months, patients have usually completed physical therapy and are quite active, and most patients consider the hip to have recovered fully by this time(12). Of the patients, 35 were male and 59 were female. The mean age of patients in this study was 57.1 ± 14.6 years, and their mean BMI was 29.3 ± 4.5 kg / m2.

In recent years, in the literature it is seen that patients’ average age has decreased and that their mean BMI is lower than 30 kg / m² due to the advances in surgical and anesthetic techniques, increased durability of the implants, improvements in implant designs and accelerated rehabilitation approaches. The number of female patients in the literature is greater than the number of male patients (3,9,13). The age, gender, and BMI values of the patients in our study are ??consistent with those in the literature. Of the patients in the study, 58.5% lived in apartments and 81.9% resided in the city center (Table 1).

Due to their living areas and means of transport, the patients performed the following activities in their daily lives very often: rising from the sitting position to standing position, walking, and climbing up and down the stairs (7). Therefore, walking, climbing up and down the stairs, and rising from the sitting position to standing position were important expectations for 97.9%, 96.8% and % 90.4 of the patients included in the study respectively. Of the patients, 92.6% were pleased with the improvement in their ability to rise from sitting position to standing position, 76.6% with the improvement in their ability to walk and 73.4% with the improvement in their ability to climb up and down the stairs (Table 2,3).

This condition indicates that patients' expectations were realistic, and that their expectations were associated with their social status. Approximately 25% of these patients were dissatisfied with the improvement in their ability to walk, and to climb up and down the stairs. Thus, it is recommended that patients’ satisfaction levels should be increased by developing problem-specific treatment approaches aiming to resolve patient dissatisfaction. As in the Far East and Middle Eastern countries, old style squat toilets are used in our society too (5).

However, 90.4% of the participants of our study used flush toilets. Eating on the floor and sitting cross-legged are often used in everyday life in our society. Of the patients, 18.1% said that they ate on the floor and 84% stated that they were unable to sit cross-legged (Table 2). Squat kneeling, a part of salat, and sitting cross-legged are frequently used positions during praying in our society (7). In our study, while 19.1% of the patients performed salat in the normal way, 31.9% performed it by sitting on a chair. For fear of causing damage to the prosthesis, patients usually restrict some movements such as sitting cross-legged, squatting and kneeling which require a high hip and knee flexion, which leads to changes in their daily living habits (3,5,7). These changes were obviously observed in our patients (Table 1).

The primary aim of total joint arthroplasty is to reduce pain and increase function (13). While THA was previously performed in order to resolve problems related to arthritis in elderly patients, in recent years, it has been performed in young patients who are more active individuals in order to improve the quality of life and joint function by reducing pain. Therefore, the younger the patients are the higher the expectations are (14). In a study carried out by Tekin et al. (7), the most important expectation of patients having undergone total knee arthroplasty (TKA) was reduction in pain. In our study, THA patients’ expectation regarding pain relief took the 6th place (93.6%) and expectation regarding night time pain relief took the 20th place (75.5%). Of the patients, 97.9% stated that the operation reduced the pain (Table 2). TKA patients’ primary expectation is thought to be pain reduction, because they usually undergo surgery at an old age (2,5,7,13).

The mean age of THA patients is lower and these patients are operated at an early age. Therefore, their primary expectation is the enhancement of functional activities. In our study, the expectation the patients considered the most important was the improvement in the walking ability (97.9%). This difference is associated with the purposes of using hip and knee joints in everyday life (13). In our study, the patients younger than 65 years of age had more expectations than did the patients over 65 years of age. A review of the literature published in recent years revealed that younger patients had more expectations (3).

Our results are consistent with those in the literature. The young patients had more expectations than did the elderly patients (Table 4). In our study, male and female patients have different expectations. As improvement of performing daily activities around home was more important for females improvement of performing daily activities away from home was more important for males (Table 5). We tought the reason for this is that males and femalse have different roles in our society.

In our study, for the patients whose BMI was lower than 30 kg / m², relieve day time pain, improvement to use public transport or private vehicles, eliminate need for medications and improvement of sexual activity were important. At the same time, patients with lower BMI had more expectations than did others (Table 6). The reason why those, whose BMI was more than 30 kg / m², had fewer expectations was that they were not able to go out much. Studies revealed that obese patients with total joint arthroplasty had a more sedentary life style and that their activity level was less (15). Our results are consistent with those in the literature.

It was found that the calorie balance and weight can be controlled through regular physical activity, diet, lifestyle changes and cognitive behavioral therapy (15). Therefore, we consider that patients with higher BMI can control their body weight with an appropriate diet, a physical activity program and lifestyle changes, and thus can increase their expectations and satisfaction levels. In a study conducted by Mancuso et al., it was found that patients with poor hip functions had higher expectations than did patients with good hip function (9).

In our study, for the patients with poor Harris Hip Scores, expectations were of less importance. However, for the patients with good Harris Hip Scores, expectations were of more importance (Table 7). The mean age of the patients in our study was lower than that of the patients in Mancuso et al.'s study, and since young patients had better functions, they had greater expectations. In conclusion, the highest expectations in our study were observed in the development of functional activities such as walking, climbing stairs up and down and performing daily activities. The expectations concerned least by the patients were the possibility to work again and the development of sexual activity.

In our study, the most important expectations for THA patients were the ones regarding functionality, which was similar to the results in the literature. Patients’ age, gender, BMI, and Harris hip scores affected their expectations. When the subgroups of these parameters were considered, there was a significant difference between the groups in terms of expectations. In our study, the parameters the patients were most satisfied with were that the operation reduced the pain (98.6%) and that they were able to rise from the sitting position to the standing position (92.6%). What they were least satisfied with were the activity and working level (73.4%), the ability to climb up and down the stairs (73.4%) and the activity and working level in the last 3 months (72.3%). It is possible to increase the quality of patient care by determining patients’ limitations through satisfaction surveys and then by arranging problem-specific treatment programs to resolve these limitations.

There are several limitations to this study. First of all, although the study was performed in one of the biggest cities in Turkey and it included patients from all over the country, it was conducted at a single center and the number of patients was limited; therefore, the results obtained cannot be generalized. The second one was that we retrospectively studied only post-operative patients’ expectations. Studies to be conducted from now on should prospectively evaluate patients during the preoperative period in terms of their expectations, and in the postoperative period, it should be identified whether these expectations were realized or not.

Moreover, clearer results should be obtained through detailed statistical analyses (regression and correlation analyses). The third one was that we tried to reach the patients by telephone and invited them to the clinic where they were to be evaluated. However, the majority of the patients could not be reached since the telephone numbers we obtained were inaccessible.

References:

  1. Unver B, Donmez B, Karatosun V. The effect of the prosthesis type on inpatient functional status and length of hospitalization in primary total hip arthroplasties. Joint Diseases and Related Surgery 2006;17:123-7.
  2. Mancuso CA, Graziano S, Briskie LM, Peterson MG, Pellicci PM, Salvati EA, et al. Randomized trials to modify patients’ preoperative expectations of hip and knee arthroplasties. Clinical Orthopaedics Related Research 2008;466:424-31
  3. . Mancuso CA, Jout J, Eduardo AS, Sculco TP. Fullfillment of patients’ expectations for total hip arthroplasty. Journal of Bone and Joint Surgery American Volume. 2009;91:2073-8
  4. . Hawker GA. Who, when, and why total joint replacement surgery? The patient's perspective. Current Opinion in Rheumatology 2006;18:526-30
  5. . Mulholland SJ, Wyss UP. Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants. International Journal of Rehabilitation Research 2001;24:191-8.
  6. Mancuso C, Altchek D. Patients’ expectations of shoulder surgery. Journal of Shoulder Elbow Surgery 2002;11(6):541-9.
  7. Tekin B, Unver B, Karatosun V. Investigation of Expectations in Patients with Total Knee Arthroplasty. Acta Orthopaedica et Traumatologica Turcica 2012;46(3):174-80
  8. Salmon P, Hall GM, Peerbhoy D, Shenkin A, Parker C. Recovery from hip and knee arthroplasty: Patients' perspective on pain, function, quality of life, and well-being up to 6 months postoperatively. Archives of Physical Medicine and Rehabilitation 2001;82:360-6.
  9. Mancuso CA, Sculco TP, Salvati EA. Patients with poor preoperative functional status have high expectations of total hip arthroplasty. Journal of Arthroplasty 2003;18:872-8.
  10. Haddad FS, Garbuz DS, Chambers GK, Jagpal TJ, Masri BA, Duncan CP. The expectations of patients undergoing revision hip arthroplasty. Journal of Arthroplasty 2001;16:87–91
  11. . Van den Akker-Scheek I, Van Raay JJ, Reininga IH, Bulstra SK, Zijlstra W, Stevens M. Reliability and concurrent validity of the Dutch hip and knee replacement expectations surveys. BMC Musculoskeletal Disorders 2010; 11:242.
  12. Unver B, Karatosun V, Gunal I. Assessing the results of thrust plate prosthesis: a comparison of four different rating systems. Clinical Rehabilitation 2005; 19:654-8.
  13. Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Comparing patient outcomes after THA and TKA. Clinical Orthopaedics Related Research 2010;468:542-6.
  14. Weller IMR, Kunz M. Physical activity and pain following total hip arthroplasty. Physiotherapy 2007;93:23-9.
  15. Unver B, Karatosun V, Bakirhan S, Gunal I. Effects of total knee arthroplasty on body weight and functional outcome. Journal of Physical Therapy Science 2009;21:201-6.

    Table I. Demographic Features

 

Demographic features

 

Value 

%

Age

 

57.1±14.6

 

BMI(kg/m)

 

29.3± 4.5

 

Harris Hip Score

Right 

92.7± 1.6

 

 

Left

93.2± 8.8

 

Sex

Female

59

62.8

 

Male

35

37.2

Job

Housewife

38

40.5

 

Retired

35

37.2

 

Working 

21

22.3

Marital status

Married

74

78.7

 

Unmarried

20

21.3

Home Style

Detached house 

39

41.5

 

Apartment

55

58.5

Stay with whom?

Alone

11

11.7

 

With family

83

88.3

Stayying place

Center

77

81.9

 

Provincial

17

18.1

Depression

Yes 

17

18.1

 

No

77

81.9

Charnley classification

Class A

58

61.7

 

Class  B

32

34.0

 

Class C

4

4.3

Eating

At table 

77

81.9

 

Sitting ground

17

18.1

Toilet

Closet 

85

90.4

 

Alla turca  

9

9.6

Sitting cross legged

Yes

15

16.0

 

No

79

84.0

Performe prayer

Yes

  Normal

18

19.1

  Sitting on chair

30

32.0

 

No

46

48.9

 

 

 

EXPECTATİONS

 

IMPORTANCE

 

 

 

Important

Not important

Total

Improve ability to walk

n

%

92

97.9

2

2.1

94

100.0

Improve ability to climb up stairs

n

%

91

96.8

3

3.2

94

100.0

Improve ability to climb down

n

%

91

96.8

3

3.2

94

100.0

Improve ability to do daily activities

n

%

90

95.7

4

4.3

94

100.0

Get rid of limp

n

%

89

94.7

5

5.3

94

100.0

Improve ability to stand

n

%

88

93.6

6

6.4

94

100.0

Relieve daytime pain

n

%

88

93.6

6

6.4

94

100.0

Improve ability to change position 

n

%

85

90.4

9

9.6

94

100.0

Improve ability to comminucate with others (play with your children, visit your neighbour etc.)

n

%

85

90.4

9

9.6

94

100.0

Improve ability to get in/out of bed, chair, car

n

%

83

88.3

11

11.7

94

100.0

Improve ability to cut toenails

n

%

82

87.2

12

12.8

94

100.0

Improve ability to put on shoes and socks

n

%

81

86.2

13

13.8

94

100.0

Eliminate need for medications

n

%

70

74.5

24

15.5

94

100.0

Improve psychological well-being

n

%

79

84.0

15

16.0

94

100.0

Remove need for cane or assistive device

n

%

79

84.0

15

16.0

94

100.0

Improve ability to squat

n

%

79

84.0

15

16.0

94

100.0

Improve ability to use public transport or private vehicles

n

%

78

83.0

16

17.0

94

100.0

Improve to participate recreational activities (dance, travel,etc.)

n

%

74

78.7

20

15.3

94

100.0

Improve ability to perform daily activities around home

n

%

73

77.7

21

22.3

94

100.0

Relieve nighttime pain 

n

%

71

75.5

23

24.5

94

100.0

Regular sleep

n

%

70

74.5

24

25.5

94

100.0

Improve ability to perform daily activities away from home

n

%

59

62.8

35

37.2

94

100.0

Improve ability to exercise and play sports

n

%

41

43.6

53

56.4

94

100.0

Improve sexual activity

n

%

34

36.2

60

63.8

94

100.0

Have possibility to work in a job again

n

%

12

12.8

82

87.2

94

100.0

 

Table II. Expectation Survey

Improve sexual activity

n

%

34

36.2

60

63.8

94

100.0

Have possibility to work in a job again

n

%

12

12.8

82

87.2

94

100.0

Table III. Clinical Satisfaction Survey

Clinical Parameters

 

Satisfaciton

 

 

 

Satisfied

Not satisfied

Total

The operation reduced medical requirement for the pain

 

n

%

93

1.1

1

98.9

94

100.0

The operation reduced pain 

n

%

92

97.9

2

2.1

94

100.0

Hip status compared to last up visits

n

%

92

97.9

2

2.1

94

100.0

The ability to stand up from sittin position

 

n

%

87

92.6

7

7.4

94

100.0

Patient satisfaction with the results

n

%

87

92.6

7

7.4

94

100.0

The time/length when walk with support

 

n

%

83

88.3

11

11.7

94

100.0

The operation increased functions

n

%

82

87.2

12

12.8

94

100.0

The degree of hip pain

n

%

80

85.1

14

14.9

94

100.0

The degree of limp

 

n

%

77

81.9

17

18

94

100.0

Often need support during walking

n

%

76

80.9

18

19.1

94

100.0

The time/length when walk without support

 

n

%

72

76.6

22

23.4

94

100.0

The ability to wear socks and shoes

n

%

70

74.5

24

25.5

94

100.0

Activities and working level

n

%

69

73.4

25

26.6

94

100.0

The ability to climb up and down stairs

n

%

69

73.4

25

26.6

94

100.0

Activities and working level at last 3 months

n

%

68

72.3

26

27.7

94

100.0

 

 

Table IV. Investigation of Expectations and Ratios by Age

Expectations

Age (year)

 

>65 year (n=35)(%37.2)

<65 year (n=59)(%62.8)

Total (n=94)(%100.0)

P values

Important

Not important

Important

 

Not important

Important

Not important

n

%

n

%

n

%

n

%

n

%

n

%

 

Relieve daytime pain

31

88.6

4

11.4

57

96.6

2

3.4

88

93.6

6

6.4

.123

Relieve nighttime pain 

20

57.1

15

42.9

51

86.4

8

13.6

71

75.5

23

24.5

.001

Improve ability to walk

33

94.3

2

5.7

59

100.0

0

0.0

92

97.9

2

2.1

.063

Remove need for cane or assistive device

28

80.0

7

20.0

51

86.4

8

13.6

79

84.0

15

16.0

.410

Improve ability to stand

32

91.4

3

8.6

56

94.9

3

5.1

88

93.6

6

6.4

.504

Improve ability to climb up stairs

32

91.4

3

8.6

59

100.0

0

0.0

91

96.8

3

3.2

.022

Improve ability to climb down

32

91.4

3

8.6

59

100.0

0

0.0

91

96.8

3

3.2

.022

Improve ability to get in/out of bed, chair, car

30

85.7

5

14.3

53

89.8

6

10.2

83

88.3

11

11.7

.548

Improve ability to squat

28

80.0

7

20.0

51

86.4

8

13.6

79

84.0

15

16.0

.410

Improve ability to use public transport or private vehicles

24

68.6

11

31.4

54

91.5

5

8.5

78

83.0

16

17.0

.004

A regular slep

22

62.9

13

37.1

48

81.4

11

18.6

70

74.5

24

25.5

.047

Eliminate need for medications

25

71.4

10

28.6

55

93.2

4

6.8

80

85.1

14

14.9

.004

Improve ability to do daily activities

32

91.4

3

8.6

58

98.3

1

1.7

90

95.7

4

4.3

.110

Improve ability to exercise and play sports

11

31.4

24

68.6

30

50.8

29

49.2

41

43.6

53

56.4

.066

Improve ability to change position

30

85.7

5

14.3

55

93.2

4

6.8

85

90.4

9

9.6

.232

Improve ability to comminucate with others

30

85.7

5

14.3

55

93.2

4

6.8

85

90.4

9

9.6

.232

Improve to participate recreational activities

27

77.1

8

22.9

47

79.7

12

20.3

74

78.7

20

21.3

.773

Have possibility to work in a job again

3

8.6

32

91.4

9

15.3

50

84.7

12

12.8

82

81.7

.348

Improve sexual activity

5

14.3

30

85.7

29

49.2

30

50.8

34

36.2

60

63.8

.001

Improve ability to cut toenails

27

77.1

8

22.9

55

93.2

4

6.8

82

87.2

12

12.8

.024

Improve ability to put on shoes and socks

27

77.1

8

22.9

54

91.5

5

8.5

81

86.2

13

13.8

.051

Improve psychological well-being

29

82.9

6

17.1

50

84.7

9

15.3

79

84.0

15

16.0

.809

Get rid of limp

32

91.4

3

8.6

57

96.6

2

3.4

89

94.7

5

5.3

.279

Improve ability to perform daily activities around home

24

68.6

11

31.4

49

83.1

10

16.9

73

77.7

21

22.3

.103

Improve ability to perform daily activities away from home

22

62.9

13

37.1

37

62.7

22

37.3

59

62.8

35

37.2

.989

 

 

Table VI. Investigation of Expectations and Ratios by BMI

 

Expectations

BMI (kg/m²)

 

>30 kg/ m² (n=37)(%39.4)

<30 kg/ m² (n=57)(%60.6)

Total (n=94)(%100.0)

P values

Important

Not important

Important

 

Not important

Important

Not important

n

%

n

%

n

%

n

%

n

%

n

%

 

Relieve daytime pain

31

88.6

4

11.4

57

96.6

2

3.4

88

93.6

6

6.4

.123

Relieve nighttime pain 

20

57.1

15

42.9

51

86.4

8

13.6

71

75.5

23

24.5

.001

Improve ability to walk

33

94.3

2

5.7

59

100.0

0

0.0

92

97.9

2

2.1

.063

Remove need for cane or assistive device

28

80.0

7

20.0

51

86.4

8

13.6

79

84.0

15

16.0

.410

Improve ability to stand

32

91.4

3

8.6

56

94.9

3

5.1

88

93.6

6

6.4

.504

Improve ability to climb up stairs

32

91.4

3

8.6

59

100.0

0

0.0

91

96.8

3

3.2

.022

Improve ability to climb down

32

91.4

3

8.6

59

100.0

0

0.0

91

96.8

3

3.2

.022

Improve ability to get in/out of bed, chair, car

30

85.7

5

14.3

53

89.8

6

10.2

83

88.3

11

11.7

.548

Improve ability to squat

28

80.0

7

20.0

51

86.4

8

13.6

79

84.0

15

16.0

.410

Improve ability to use public transport or private vehicles

24

68.6

11

31.4

54

91.5

5

8.5

78

83.0

16

17.0

.004

A regular slep

22

62.9

13

37.1

48

81.4

11

18.6

70

74.5

24

25.5

.047

Eliminate need for medications

25

71.4

10

28.6

55

93.2

4

6.8

80

85.1

14

14.9

.004

Improve ability to do daily activities

32

91.4

3

8.6

58

98.3

1

1.7

90

95.7

4

4.3

.110

Improve ability to exercise and play sports

11

31.4

24

68.6

30

50.8

29

49.2

41

43.6

53

56.4

.066

Improve ability to change position

30

85.7

5

14.3

55

93.2

4

6.8

85

90.4

9

9.6

.232

Improve ability to comminucate with others

30

85.7

5

14.3

55

93.2

4

6.8

85

90.4

9

9.6

.232

Improve to participate recreational activities

27

77.1

8

22.9

47

79.7

12

20.3

74

78.7

20

21.3

.773

Have possibility to work in a job again

3

8.6

32

91.4

9

15.3

50

84.7

12

12.8

82

81.7

.348

Improve sexual activity

5

14.3

30

85.7

29

49.2

30

50.8

34

36.2

60

63.8

.001

Improve ability to cut toenails

27

77.1

8

22.9

55

93.2

4

6.8

82

87.2

12

12.8

.024

Improve ability to put on shoes and socks

27

77.1

8

22.9

54

91.5

5

8.5

81

86.2

13

13.8

.051

Improve psychological well-being

29

82.9

6

17.1

50

84.7

9

15.3

79

84.0

15

16.0

.809

Get rid of limp

32

91.4

3

8.6

57

96.6

2

3.4

89

94.7

5

5.3

.279

Improve ability to perform daily activities around home

24

68.6

11

31.4

49

83.1

10

16.9

73

77.7

21

22.3

.103

Improve ability to perform daily activities away from home

22

62.9

13

37.1

37

62.7

22

37.3

59

62.8

35

37.2

.989

 

Table VII . Investigation of Expectations and Ratios by Harris

Expectations

Harris Hip Score

 

Better (n=73)(%77.7)

Worse (n=21)(%22.3)

Total (n=94)(%100.0)

P values

Important

Not important

Important

 

Not important

Important

Not important

n

%

n

%

n

%

n

%

n

%

n

%

 

Relieve daytime pain

71

97.3

2

2.7

17

81.0

4

19.0

88

93.6

6

6.4

.007

Relieve nighttime pain 

58

79.5

15

20.5

13

61.9

8

38.1

71

75.5

23

24.5

.099

Improve ability to walk

73

100.0

0

0.0

19

90.5

2

9.5

92

97.9

2

2.1

.008

Remove need for cane or assistive device

66

90.4

7

9.6

13

61.9

8

13.8

79

84.0

15

16.0

.002

Improve ability to stand

70

95.9

3

4.1

18

85.7

3

14.3

88

93.6

6

6.4

.093

Improve ability to climb up stairs

73

100.0

0

0.0

18

85.7

3

14.3

91

96.8

3

3.2

.001

Improve ability to climb down

73

100.0

0

0.0

18

85.7

3

14.3

91

96.8

3

3.2

.001

Improve ability to get in/out of bed, chair, car

67

91.8

6

8.2

16

76.2

5

23.8

83

88.3

11

11.7

.050

Improve ability to squat

64

87.7

9

12.3

15

71.4

6

28.6

79

84.0

15

16.0

.073

Improve ability to use public transport or private vehicles

64

87.7

9

12.3

14

66.7

7

33.3

78

83.0

16

17.0

.024

A regular slep

58

79.5

15

20.5

12

57.1

9

42.9

70

74.5

24

25.5

.039

Eliminate need for medications

66

90.4

7

9.6

14

66.7

7

33.3

80

85.1

14

14.9

.007

Improve ability to do daily activities

72

98.6

1

1.4

18

85.7

3

14.3

90

95.7

4

4.3

.010

Improve ability to exercise and play sports

31

42.5

42

57.5

10

47.6

11

52.4

41

43.6

53

56.4

.675

Improve ability to change position

67

91.8

6

8.2

18

85.7

3

14.3

85

90.4

9

9.6

.405

Improve ability to comminucate with others

68

93.2

5

6.8

17

81.0

4

19.0

85

90.4

9

9.6

.094

Improve to participate recreational activities

59

80.8

14

19.2

15

71.4

6

28.6

74

78.7

20

21.3

.354

Have possibility to work in a job again

11

15.1

62

84.9

1

4.8

20

95.2

12

12.8

82

87.2

.212

Improve sexual activity

31

42.5

42

57.5

3

14.3

18

85.7

34

36.2

60

63.8

.018

Improve ability to cut toenails

67

91.8

6

8.2

15

71.4

6

28.6

82

87.2

12

12.8

.014

Improve ability to put on shoes and socks

67

91.8

6

8.2

14

66.7

7

33.3

81

86.2

13

13.8

.003

Improve psychological well-being

62

84.9

11

15.1

17

81.0

4

19.0

79

84.0

15

16.0

.661

Get rid of limp

70

95.9

3

4.1

19

90.5

2

9.5

89

94.7

5

5.3

.330

Improve ability to perform daily activities around home

58

79.5

15

20.5

15

71.4

6

28.6

73

77.7

21

22.3

.437

Improve ability to perform daily activities away from home

49

67.1

24

32.9

10

47.6

11

51.4

59

62.8

35

37.2

.103

 

 

 

 

 

 

 

This is a peer reviewed paper 

Please cite as : 

J.Orthopaedics 2012;9(4)e8

URL: http://www.jortho.org/2012/9/4/e8

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