Clinical evaluation of hip joint diseases: total hip arthroplasty to support patients’ quality of life

Abstract

Purpose

In Japan's super-aged society, medical care supporting the patients' quality of life (QOL) is becoming increasingly important. This study aimed to evaluate the current applications of patient-reported outcome measures (PROMs), with a focus on Japanese patients with hip osteoarthritis (OA) undergoing total hip arthroplasty (THA).

Methods

We reviewed the literature on PROMs, with a focus on (i) available guidelines, (ii) validated questionnaires in Japanese-version, and (iii) methods to assess responsiveness and interpretation.

Results

Several guidelines were available, including a checklist for methodological quality, the study protocol, and reporting of PROMs. The Short-Form 36/12-Item Health Survey is used for multidimensional evaluation. The EuroQol 5 dimension (EQ-5D) is the most commonly used preference-based utility. To assess disease-specific QOL in patients with hip OA undergoing THA, the Western Ontario and McMaster Universities Osteoarthritis Index, Oxford Hip Score, Hip Disability and Osteoarthritis Outcome Score, Forgotten Joint Score-12, and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire are used. The Central Sensitization Inventory can be used to assess central sensitivity syndrome. Ikigai-9 is used to assess ikigai (a comprehensive concept that gives meaning to life) and is also validated in English. The smallest detectable change (SDC) can be used to evaluate responsiveness. The minimal important change, minimal clinically important difference, and patient acceptable symptom state can be used to aid in interpreting results.

Conclusions

Several instruments and techniques are established to facilitate shared decision-making for Japanese patients undergoing THA to support their QOL. This review provides a broad overview of PROMs that can benefit future studies.