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Comparative outcomes of total hip and knee arthroplasty: a prospective cohort study
  1. David Hamilton1,
  2. G Robin Henderson2,
  3. Paul Gaston1,
  4. Deborah MacDonald1,
  5. Colin Howie1,
  6. A Hamish R W Simpson1
  1. 1Department of Orthopaedics and Trauma, University of Edinburgh and Royal Infirmary of Edinburgh, Little France, Edinburgh, UK
  2. 2Department of Medicine of the Elderly, Royal Infirmary of Edinburgh, Little France, Edinburgh, UK
  1. Correspondence to Dr David Hamilton, Department of Orthopaedics and Trauma Chancellor's Building University of Edinburgh 49 Little France Crescent Edinburgh EH16 4SB, UK; d.f.hamilton{at}


Purpose The comparative outcome of primary hip and knee arthroplasty is not well understood. This study aimed to investigate the outcome and satisfaction of these procedures and determine predictive models for 1 year patient outcome with a view to informing surgical management and patient expectations.

Study design Prospective cohort study of all primary hip and knee arthroplasty procedures performed at the Royal Infirmary of Edinburgh between January 2006 and November 2008. General health (SF-12) and joint specific function (Oxford Score) was assessed pre-operatively and at 6 and 12 months post-operatively. Patient satisfaction was assessed at 12 months.

Results 1410 total hip arthroplasty (THA) and 1244 total knee arthroplasty (TKA) procedures were assessed. Oxford Score improved by 4.9 points more in THA patients than in TKA patients. SF-12 physical scores were on average 2.7 points greater in the THA patients at one year. Satisfaction was also greater (91%) following THA compared with TKA (81%). Regression modelling was not able to predict individual patient outcome; however, mean pre-operative Oxford Scores were found to be strong predictors of mean post-operative Oxford Scores for each procedure. Age, gender and pre-operative general health scores did not influence these models.

Conclusions Both THA and TKA confer substantial improvement in patient outcome; however, greater joint specific, general health and satisfaction scores are reported following THA. This difference is physical in nature. Regression models are presented that can be applied to predict mean hip/knee arthroplasty outcome based on preoperative values.

  • Arthroplasty outcome hip knee

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  • Funding Stryker UK provide funding to the Department of Orthopaedics and Trauma, University of Edinburgh to support the patient database. At the time of this work DH received a PhD studentship from the Medical Research Council doctoral training scheme and Stryker UK. These bodies had no role in the design; in the collection, analysis and interpretation of the data; or in the writing of the article and the decision to submit for publication.

  • Competing interests None.

  • Ethics approval Scotland A Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.