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Preoperative importance of improvement and postoperative satisfaction in patients undergoing total hip replacement



We aimed to correlate the preoperative importance of improvement and postoperative satisfaction in patients undergoing total hip replacement with the functional pre- and postoperative (12 months) status.


Functional status was assessed by Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) and the preoperative importance was rated for all WOMAC and 13 items of daily living. The postoperative satisfaction was assessed alongside these 37 items.


One hundred eighteen patients with a mean age of 59 (35–84) years (54% women) were included. Through surgery, WOMAC score increased from 39.5 to 78.6. Preoperative importance was high (73.1) and postoperative satisfaction was moderate to high (66.8). Younger patients were more satisfied (72.4 vs. 60.2, p = 0.02). After adjustment for age and gender, the preoperative functional status correlated significantly with the importance (β = 0.60, CI = 0.37–0.62), and so did postoperative functional status and satisfaction (β = −0.69, CI = −0.97 to −0.68). Satisfaction in WOMAC-related items correlated with the gain in WOMAC score (β = 0.35, CI = 0.16–0.45).


The high patient-rated importance of improvement and satisfaction are associated with age and gender and correlate with the corresponding functional status, i.e. its change.

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We would like to thank Stephan Kirschner, M.D., for his helpful conceptual input to this study. We also appreciate the support of Yvonne Rabe in recruiting patients. The authors are furthermore most grateful to Ms. Heike Voigt for the committed assistance in data assessment and documentation. The data and part of the results are based on the doctoral thesis of S Biakowski (in preparation).

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The authors declare that they have no conflict of interest.

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Correspondence to Klaus-Peter Günther.

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Schäfer, T., Biakowski, S., Walther, A. et al. Preoperative importance of improvement and postoperative satisfaction in patients undergoing total hip replacement. Eur Orthop Traumatol 1, 143–152 (2011).

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  • Expectation
  • Functional status
  • Importance
  • Outcomes
  • Satisfaction
  • Total hip replacement