The Relationship Between Patient-Reported Outcome Measures (PROMs) in Patients Undergoing Hip and Knee Joint Replacement Surgery and Social Deprivation on the Wirral

Abstract

Objective: This study aimed to investigate the associa-tion between patient-reported outcome measures (PROMs), both pre- and post-operatively, and socio-economic deprivation among patients undergoing hip and knee replacement surgeries in the diverse socioeconomic region of Wirral.

Methods: A retrospective cohort study was conducted, involving 1666 adult patients who underwent hip or knee replacement procedures between 2012 and 2019. Socioeconomic deprivation was assessed using the Index of Multiple Deprivation (IMD). Pre- and post-operative outcomes were measured using the Oxford Hip and Knee scores.

Results: The mean scores for both pre-and post-operative assessments (Q1 and Q2) exhibited a strong positive correlation with PROM scores, regardless of gender, across both hip and knee replacements. However, the mean difference in scores between Q1 and Q2 showed no significant correlation with the IMD decile. Notably, patients residing in areas of higher socioeconomic deprivation demonstrated lower PROMs both before and after the surgery.

Conclusion: The Oxford Hip and Knee scores are widely employed for evaluating health status in patients. In our study, these scores were influenced by IMD decile, supporting the holistic assessment approach employed by the treating unit, which does not rely solely on PROM scores as a trigger for arthroplasty discussions. Furthermore, our findings align with the practice of NHS Digital, which publishes PROM scores based on changes in PROM scores pre- and post-operation rather than absolute PROM scores. This approach appears to be less influenced by deprivation in the catchment area, as the improvement or change in scores was poorly correlated with socioeconomic factors.