Michael Nganga1,2, Donald Bramwell1,2, Jenifer Monaghan3, Christine Doerr3, Graham Mercer1,3, Jeganath Krishnan1,2,4. 1. College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia. 2. The International Musculoskeletal Research Institute Inc., Adelaide, South Australia, Australia. 3. Department of Orthopaedics, Repatriation General Hospital, Adelaide, South Australia, Australia. 4. Department of Orthopaedic Surgery & Trauma, Flinders Medical Centre, Adelaide, South Australia, Australia.
Abstract
RATIONALE AIMS AND OBJECTIVES: The demand for arthroplasty is increasing and will continue to rise with an ageing population. Obesity and lengthy waiting time for Total Joint Replacement (TJR) have been associated with poorer outcomes postoperatively. This study aimed to evaluate the Multi-Attribute Prioritisation Tool (MAPT) for TJR patients. The primary objective was to explore if patients prioritised by the MAPT had an improvement in score post-operative. Further to identify any relationship between MAPT score and length of time on the waiting list or obesity. METHOD: This retrospective cohort study included 308 patients undergoing total hip (n = 114) or total knee (n = 194) arthroplasty. We examined preoperative and postoperative MAPT scores of patients who had total hip or total knee arthroplasty. After assessing the difference between postoperative and preoperative MAPT scores, patients scores were compared to BMI and waiting time classes. BMI was allocated to less than 30, 30-35, 35-40 and greater than 40. Duration of time on the waiting list was allocated to less than 6 months and greater than 6 months. RESULTS: THA and TKA patients MAPT scores improved from a preoperative score of 71.39-5.26 postoperative and 54.11 to 7.13 respectively. Patients whose MAPT scores placed them in the high priority category had a significant relationship with length of time on the waiting list (p < 0.01). There were no significant differences between length of time on the waiting list and improvement scores for low priority and middle priority patients. BMI had minimal effect on patients improvement score postoperative. CONCLUSION: TJR patients prioritised by the MAPT questionnaire do experience pain relief as portrayed by a reduction in postoperative MAPT score. A longer length of time on the waiting list seems to effect the improvement a high priority patient can have postoperative.
RATIONALE AIMS AND OBJECTIVES: The demand for arthroplasty is increasing and will continue to rise with an ageing population. Obesity and lengthy waiting time for Total Joint Replacement (TJR) have been associated with poorer outcomes postoperatively. This study aimed to evaluate the Multi-Attribute Prioritisation Tool (MAPT) for TJR patients. The primary objective was to explore if patients prioritised by the MAPT had an improvement in score post-operative. Further to identify any relationship between MAPT score and length of time on the waiting list or obesity. METHOD: This retrospective cohort study included 308 patients undergoing total hip (n = 114) or total knee (n = 194) arthroplasty. We examined preoperative and postoperative MAPT scores of patients who had total hip or total knee arthroplasty. After assessing the difference between postoperative and preoperative MAPT scores, patients scores were compared to BMI and waiting time classes. BMI was allocated to less than 30, 30-35, 35-40 and greater than 40. Duration of time on the waiting list was allocated to less than 6 months and greater than 6 months. RESULTS: THA and TKA patients MAPT scores improved from a preoperative score of 71.39-5.26 postoperative and 54.11 to 7.13 respectively. Patients whose MAPT scores placed them in the high priority category had a significant relationship with length of time on the waiting list (p < 0.01). There were no significant differences between length of time on the waiting list and improvement scores for low priority and middle priority patients. BMI had minimal effect on patients improvement score postoperative. CONCLUSION: TJR patients prioritised by the MAPT questionnaire do experience pain relief as portrayed by a reduction in postoperative MAPT score. A longer length of time on the waiting list seems to effect the improvement a high priority patient can have postoperative.
Entities:
Keywords:
Multi-attribute prioritisation tool; Total hip replacement; Total knee replacement
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