| Summary: | <strong>Introduction</strong>
Routinely-collected patient-reported outcome measures (PROMs) have been useful to quantify and quality-assess provision of total hip replacement (THR) and total knee replacement (TKR) in the UK for the past decade. This study aimed to explore whether the outcome following primary THR and TKR has improved over the past seven years.
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<strong>Methods</strong>
Secondary data analysis of 277,430 primary THR and 308,007 primary TKR from the NHS PROMs programme. Outcome measures were: (i) post-operative Oxford hip/knee score (OHS/OKS); (ii) proportion of patients achieving a clinically important improvement in joint function (responders); (iii) quality of life; (iv) patient satisfaction; (v) perceived success; and (vi) complication rates. Outcomes were compared based on year of surgery.
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<strong>Results</strong>
For primary THR, more recent year of surgery was associated with higher post-operative OHS (0.15 points, 95% confidence interval (CI) 0.14-0.17; p<0.001) and higher EQ-5D utility (0.002, 95% CI 0.001-0.002; p<0.001). The odds of being a responder (OR 1.02, 95% CI 1.01-1.03; p<0.001) and patient satisfaction (OR 1.02, 95% CI 1.01-1.03; p<0.001) increased with year of surgery, whilst the odds of any complication reduced (OR 0.97, 95% CI 0.97-0.98; p<0.001). No trend was found for perceived success (p=0.56). For primary TKR, more recent year of surgery was associated with higher post-operative OKS (0.21 points, 95% CI 0.19-0.22; p<0.001) and higher EQ-5D utility (0.002, 95% CI 0.002-0.003; p<0.001). The odds of being a responder (OR 1.04, 95% CI 1.03-1.04; p<0.001), perceived success (OR 1.02, 95% CI 1.01-1.02; p<0.001) and patient satisfaction (OR 1.02, 95% CI 1.01-1.02; p<0.001) all increased with year of surgery, whilst the odds of any complication reduced (OR 0.97, 95% CI 0.97-0.97; p<0.001).
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<strong>Conclusion</strong>
Nearly all patient-reported outcomes following primary THR/TKR improved by a small amount over the past seven years. Due to the high proportion of patients achieving good outcomes, PROMs following THR/TKR may need to focus on better discrimination of patients achieving high scores to be able to continue to measure improvement in outcomes.
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