Using PHIN data: Hips and Knees PROMs

5 min read

05/03/2024

PHIN publishes PROMs data for four joint replacement procedures: Primary Hip Replacement; Revision Hip Replacement; Primary Knee Replacement; and Revision Knee Replacement. For these we use the Oxford Hip Score (OHS) and Oxford Knee Score (OKS).

Both tools were designed and developed by researchers at the University of Oxford and have been well validated. For more information regarding the Oxford Hip/Knee Scores, please visit Oxford website for OHS and OKS.

Why should I be interested in Hips and Knees PROM information?

You may be considering joint replacement surgery for your hip or knee, but not sure how much it will improve your daily activities. Will you be able to walk your dog again? Go up the stairs without pain? Climb into your car comfortably? These are the kinds of questions that information about PROMs can help you answer.

The OHS and OKS are questionnaires specifically designed to capture how patients feel and function before and after surgery. Filled out by you, the patient, they provide a unique perspective on the impact of surgery on your everyday life. Unlike doctor examinations, PROMs focus on what matters most to you: your ability to do the things you want to do.

PROMs information empowers you to make a decision. By understanding how surgery can impact your specific needs and goals, you can make informed decisions about your treatment plan. Whether you are looking for a general sense of improvement or want to know if you will be able to tackle that specific activity you have been missing, PROMS information can support this.

How does PHIN calculate health gain for Hip and Knee PROMs?

Both the OHS and OKS are 12-question PROMs used to assess function and pain for patients undergoing hip or knee replacement surgery.

Each question has five possible answers, ordered in terms of increasingly poor health status. Each answer is attributed a score, with 0 representing the best possible health and 4 the worst.

To use these pre- and post- operative questionnaires to calculate a change in health status (a “health-gain” score), the scores for each questionnaire’s 12 questions are summed and the difference between the two calculated.

If the post-operative score is greater than the pre-operative score = health status has improved
If the post-operative score is equal to the pre-operative score = health status has not changed
If the post-operative score is less than the pre-operative score = health status has worsened

The results of these calculations take no account of how old or unwell patients completing these questionnaires were at the time of completion. This may alter the results and needs to be borne in mind when using this information to compare between different hospitals or consultants.

These PROM tools are also only validated for use with patients over the age of 18 on admission.

How does PHIN publish Hips and Knees PROMs information?

Our website allows people to search for hospitals who undertake Hip and Knee replacements close to where the patient lives.

After entering a location and operation (hip or knee replacement), the website will present the visitor with a list of consultants who perform the operation sorted by those closest to the chosen location.

The visitor can then switch to showing hospitals.

You can access more information about a specific hospital by clicking the “View” button and scroll to ‘Your Procedure’:

The count of Admissions for the selected operation. If the hospital also treated NHS patients, the website will show these numbers if the data are available.
Healthcare outcomes reported by patients - The total number of PROMs responses that have been used to calculate the health gain.
Healthcare outcomes reported by patients - The percentage of patients who reported again improved, no change or worsened outcome.