Insights into the impact of hip and knee arthroplasty on individuals: effect on comprehensive health status measures

Abstract

This thesis aims firstly to gain knowledge on the impact of total hip and knee arthroplasty (THA/TKA) on the patients’ health status in terms of body functions and structures, activities and participation. Secondly to provide insight into determinants that affect outcomes of the patient’s health. Part I focuses on the epidemiology and need of arthroplasties in people with hip or knee osteoarthritis (OA). It presents the impact of the COVID-pandemic on arthroplasty volumes and the impact of multiple joint involvement regarding the incidence of multiple joint arthroplasties. Part II focuses on the impact of OA and THA/TKA on patients' health status. Specifically focusing on the identification of determinants affecting patients' perspectives regarding their health status. The research centered on the associations between arthroplasty surgery and the outcomes perceived by the patients. All the studies in this part are based on data from the Leiden Orthopaedics Outcomes of Osteo-Arthritis Study (LOAS). Topics included in this part of the thesis are: differences in expectations based on gender; comparison of surgical approaches for THA and their effect on the construct ‘activity and participation’; adherence to the physical activity guideline prior to and after surgery; effect of acute postoperative pain on chronic pain.