Abstract
Background The aim of the study is to identify those patients without improved pain sensation
and functionality of the joint, thus with a potential necessity of re-intervention
by using the evaluation of the PROMs (Oxford Hip Score, European Quality of Life Scale,
EndoCert-Risk-Score). The task was to determine the value of the scores which represents
the limit above/below, which a re-examination of the patient is necessary. Additionally,
further secondary objectives such as influence of complications on scores, the percentage
of questionnaire return and the quality of the provided data in the questionnaires
were recorded to define minimal requirements on patientʼs response.
Material and Methods Members of the EndoCert certification committee developed a questionnaire for pre-
(decision on treatment) and post-operative (discharge and 3-months follow-up) use.
A total of 112 primary hip replacements and 25 hip revision arthroplasties, which
were recruited from a centre of excellence for joint replacement (EndoProthetikZentrum
der Maximalversorgung), were included in the study.
Results The return of questionnaires amounted to 80%. Quality of data in the questionnaires
declined with BMI (≥ 25), ASA classification (≥ 3), age (≥ 65) and depended on the
time point questioning. Based on the EndoCert risk score there was a significant improvement
in the experience of pain postoperatively compared to pre-operation (p < 0.05). However,
the functionality of the joint, as measured as the use of walking frames or crutches
as well as the need for help from others, did not improve. The results revealed that
there was no correlation between the incidence of complications and a detrimental
score. It was furthermore shown that patient specific attributes, e.g. age or BMI,
or perioperative performance (duration of operation) did not influence the likelihood
of a complication.
Conclusion It was shown that Oxford Hip Score and EQ-5D were not negatively influenced by complication
during hospital stay. The evaluation of the EndoCert risk score showed not improvement
between pre- and post-operative values regarding function but revealed a significant
pain relief. A further study is intended to evaluate the intensity of pain after three
months as part of an extended systemic follow-up. This could provide further insights
whether the EndoCert risk score is a suitable tool to identify unsuccessfully treated
patients.
Key words EndoCert - PROM - Net Promoter Score - quality control - follow-up examination
