Patients’ perspectives of outcomes after total knee and total hip arthroplasty: a nominal group study

BACKGROUND: While total joint replacements (TJR) are frequently performed, there is little qualitative research to define the outcomes most important to patients. METHODS: Patients who had received total hip (THR) or total knee replacements (TKR) participated in 8 nominal groups to answer the question “What result/results matter the most to a patient undergoing/having a knee or hip replacement?” Total 270 votes were allocated. RESULTS: Eight nominal groups were performed with 45 patients, 6 groups with mean age (71.1 ± 9.3), and 2 with 9 younger patients (mean age 36.8 ± 7.4). All had TJR between 2016 and 2018; overall, 40% were male, 15.6% were Black, and 75% were performed for osteoarthritis. While all groups ranked the same top 3 outcomes, responses varied with age: 1) relief of pain (46% vs. 35% in the young groups); 2) improved function including mobility (29% vs. 18% in the young groups); 3) restored quality of life (13% vs 33% of votes in the younger group). CONCLUSION: Relief of pain and restoration of function, and improved quality of life are the 3 outcomes ranked highest by patients, confirming their inclusion in TJR clinical trials.