Randomized Controlled Trial of Total Hip Arthroplasty

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints.

The WOMAC measures five items for pain (score range 0-20), two for stiffness (score range 0-8), and 17 for functional limitation (score range 0-68). Physical functioning questions cover everyday activities such as stair use, standing up from a sitting or lying position, standing, bending, walking, getting in and out of a car, shopping, putting on or taking off socks, lying in bed, getting in or out of a bath, sitting, and heavy and light household duties. Higher scores indicate worse pain, stiffness, and functional limitations.

The Harris Hip Score (HHS) is a clinician-based outcome measure frequently used for the evaluation of patients following a total hip arthroplasty.

Four subscales make up HHS. The first is pain, which measures pain severity (44 points); function, which is made up of daily activities and gait (47 points); the absence of deformity, which is a subscale that measures hip flexion, adduction, internal rotation, leg length discrepancy and range of motion measures.(4 points), and range of motion (5 points).

The survey has 10 question items and scores range from 0-100 with higher scores representing less dysfunction and better outcomes.

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints.

The WOMAC measures five items for pain (score range 0-20). Higher scores indicate worse pain.

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints.

The WOMAC measures two items for stiffness (score range 0-8). Higher scores indicate worse stiffness.

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints.

The WOMAC measures 17 items for functional limitation (score range 0-68). Physical functioning questions cover everyday activities such as stair use, standing up from a sitting or lying position, standing, bending, walking, getting in and out of a car, shopping, putting on or taking off socks, lying in bed, getting in or out of a bath, sitting, and heavy and light household duties. Higher scores indicate worse functional limitations.

How many times a patient can stand up and sit down on a chair in 30 seconds. Higher scores mean a better outcome.

How fast can a patient walk 40 meters measured in seconds. Lower scores mean a better outcome.

The time (in seconds) it takes to ascend and descend a flight of stairs. Lower scores mean a better outcome.

Maximum grip strength with dominant hand. Three squeezes are measured with Jamar Hand Dynamometer. Higher scores mean a better outcome. Force is measured in kilograms.

The 36-Item Short Form Survey (SF-36) is an self-reported measure of health. It stems from a study called the Medical Outcomes Study.

It comprises 36 questions which cover eight domains of health:

• Limitations in physical activities because of health problems.
• Limitations in social activities because of physical or emotional problems
• Limitations in usual role activities because of physical health problems
• Bodily pain
• General mental health (psychological distress and well-being)
• Limitations in usual role activities because of emotional problems
• Vitality (energy and fatigue)
• General health perceptions

Patients or individuals are asked to fill out the questionnaire (tick boxes) by themselves and then it is scored by a clinician or researcher.

Scores for the different domains are converted and pooled using a scoring key, for a total score indicating a range of low to high QOL.

painDETECT is a nine-item questionnaire that consists of seven sensory symptom items for pain that are graded from 0= never to 5= strongly, one temporal item on pain-course pattern graded -1 to +1, and one spatial item on pain radiation graded 0 for no radiation or +2 for radiating pain. A total score that ranges from -1 to 38 can be calculated from the nine items, with higher scores indicating higher levels of neuropathic pain.

Body Mass Index (BMI). Weight and height will be combined to report BMI in kg/m^2.

Rate of pain medication use (paracetamol, NSAID and opioid pain medication) in four stage rating.

• Not at all
• Few days a month
• Few days a week
• Daily

Patients keep a record of the training they do at home. The exercises are taught by the physical therapists and patients mark the number of days per week, that they have done the exercises.

Measurement of hip extension in side lying position. Measurement is done by physical therapist with a goniometer and it is reported in degrees.

Measurement of hip flexion in side lying position. Measurement is done by physical therapist with a goniometer and it is reported in degrees.

Measurement of hip inner rotation in supine position. Measurement is done by physical therapist with a goniometer and it is reported in degrees.

Measurement of hip inner rotation in supine position. Measurement is done by physical therapist with a goniometer and it is reported in degrees.

Leg length is measured from the highest point of ileum. Measurement is done by physical therapist and reported in centimeters.