“ The novelty of our study is that we’ re asking,‘ Are you, as a person, happy with what we’ ve done to your joints?’ and that’ s really the most important thing we want to know.”
“ The novelty of our study is that we’ re asking,‘ Are you, as a person, happy with what we’ ve done to your joints?’ and that’ s really the most important thing we want to know.”
NATHAN DONALDSON, DO
ARE YOU HAPPY?
Most studies on total joint replacements look at physicianreported scores, which include assessment of pain, but they overlook other important markers like mental health.
“ The novelty of our study is that we’ re asking,‘ Are you, as a person, happy with what we’ ve done to your joints?’,” says Dr. Donaldson,“ and that’ s really the most important thing we want to know.”
They receive answers from patients through a survey given over the phone or privately in clinic.
This method of patient-recorded outcomes is increasing in practice, Rogers says, because in addition to what a physician is assessing, it’ s important to understand what a patient thinks. Feedback differs depending on group, but overall, Rogers is seeing that both physical and mental scores for Children’ s Colorado patients fall within the national average.
WHAT’ S NEXT?
Rogers and Dr. Donaldson hope to continue enrolling patients as long as they’ re practicing.
“ The biggest thing for us is continuing to get a comparison of quality of life and functional ability before and after their surgery,” says Rogers.“ It’ s the idea of saying,‘ You start here and then you go up.’ That’ s the goal of the research.”
Postoperatively, they plan to follow up with a patient at two weeks, six weeks, three months, six months, one year and two years. They’ ll have the patient complete the outcomes survey each time, and they’ ll compare that with the physician assessment.
What’ s harder to gather is information on how often kids need replacements. That takes years to build. Ideally, they’ d like to follow patients for at least 25 years. Over a lifetime is even better.
Pediatric orthopedic surgeon Nathan Donaldson, DO, thoroughly evaluates and documents a patient’ s functional ability and quality of life post-surgery.
This type of long-term assessment could also help them track health-related quality of life. For example, there isn’ t yet a definitive link between joint replacement and heart health, but Dr. Donaldson says one could assume that kids are more active after a total joint replacement— meaning they might maintain a healthier heart.
Kids go off to college, move away or transition to adult medical care. Historically, that’ s why this information has been so hard to record. But what Rogers and Dr. Donaldson see so far is, at least for a kid hitting 5 or 10 years out, that survival of the joint is good, and function is good.“ The kids— some who are now adults— are all pretty happy with it,” says Rogers. •
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