Elsevier

The Journal of Arthroplasty

Volume 22, Issue 8, December 2007, Pages 1168-1173
The Journal of Arthroplasty

Original Article
Comparison of the Responsiveness of the SF-36 and WOMAC in Patients Undergoing Total Hip Arthroplasty

https://doi.org/10.1016/j.arth.2006.10.006Get rights and content

Abstract

This study examines the responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-36 (SF-36) in patients undergoing total hip arthroplasty. Eighty-nine patients completed the WOMAC and SF-36 preoperatively and postoperatively. Standardized response means (SRMs) and effect sizes (ES) were used to measure responsiveness. Mean follow-up was 17 months. The SRMs for the WOMAC ranged from −0.93 to −1.49, and the ES ranged from −1.02 to −1.53. The SRMs for the SF-36 ranged from 0.22 to 1.64, and the ES ranged from 0.20 to 1.97. The highest values occurred with the physical functioning, bodily pain, and Physical Component Summary Scales. This study demonstrates a similar level of responsiveness of the WOMAC and several components of the SF-36. This suggests that the isolated use of the SF-36 may be adequate to monitor outcomes after total hip arthroplasty. There may still be a role for the WOMAC when comparing outcomes of specific designs or techniques of total hip arthroplasty.

Section snippets

Human Subjects

This project was approved by the Institutional Review Board at the UCLA School of Medicine. Informed consent was obtained from all patients before participation.

Patient Sample

Patients were recruited through the joint replacement clinic at the UCLA School of Medicine. Patients were included if they presented with a chronic arthritic condition requiring total hip arthroplasty. Patients were excluded if their indication for surgery was acutely traumatic or due to fracture. In addition, revision arthroplasty

Patient Sample

Eighty-nine patients were recruited and had adequate data to allow complete scoring of the WOMAC and SF-36 for the preoperative visit and minimum 5-month postoperative follow-up. The patients included in the study consisted of 48 women (54%) and 41 men (46%). The mean age of the patient sample was 60 years (range, 20-91 years).

The mean follow-up period between surgery and final questionnaire administration was 17 months (range, 5-43 months). Thirty-three patients completed follow-up

Discussion

This study demonstrated an adequate level of responsiveness to clinical change after total hip arthroplasty of several components of the SF-36 when compared with the disease-specific WOMAC. Specifically, there was evidence that the physical functioning subscale, PCS Scale, and bodily pain subscale of the SF-36 have a level of responsiveness similar to that seen with the WOMAC in patients undergoing total hip arthroplasty. This suggests that the isolated use of the SF-36 may be sufficient to

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    No benefits or funds were received in support of the study.

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