“ 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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