Personality, function and satisfaction in patients undergoing total hip or knee replacement.

BACKGROUND: The aim of this study was to investigate the relationships between personality and joint-specific function, general physical and general mental health in patients undergoing total hip (THA) and knee arthroplasty (TKA). METHODS: One hundred and eighty-four patients undergoing THA and 205 undergoing TKA were assessed using the Eysneck Personality Questionnaire, brief version (EPQ-BV). General physical and mental health was measured using the Short-Form 12 (SF-12) questionnaire and the EuroQol (EQ-5D). Joint-specific function was measured using the Oxford hip or knee score. RESULTS: The "unstable introvert" personality type was associated with poorer pre-operative function and health in patients with hip arthrosis. In patients with knee arthrosis, there was poorer general health in those with "stable extrovert" and "unstable introvert" types. Personality was not an independent predictor of outcome following TKA or THA. The main predictor was pre-operative function and health. Comorbidity was an important covariate of both pre-operative and postoperative function. CONCLUSIONS: Personality may play a role in the interaction of these disease processes with function and health perception. It may also affect the response and interpretation of psychometric and patient-reported outcome measures. It may be important to characterise and identify these traits in potential arthroplasty patients as it may help deliver targeted education and management to improve outcomes in certain groups.

A pilot study to explore the predictive validity of 4 measures of falls risk in frail elderly patients.

OBJECTIVES: To test the hypothesis that scores on 4 falls risk measures will differ significantly in patients reporting recurrent falls compared with those who do not; and to explore the validity of each measure to predict such falls status. DESIGN: A convenience sample was tested to establish the sensitivity and specificity of the Functional Reach Test, Timed Up & Go test, one-leg stance test (OLST), and balance subsection of the Performance Oriented Mobility Assessment (B-POMA). A 12-month retrospective falls history was used to identify recurrent fallers. SETTING: A day hospital for the elderly. PARTICIPANTS: Convenience sample of 30 day hospital patients. The inclusion criteria were: ability to rise from a chair and walk 6m; no severe cognitive impairment or blindness; age 65 years or older. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Scores on the 4 tests and retrospective falls histories. RESULTS: Scores on the B-POMA and OLST showed significant differences between fallers and nonfallers (P<.05). An OLST time of 1.02 seconds or less (odds ratio [OR]=15.2; 95% confidence interval [CI], 1.72-133.95) and B-POMA score of 11 or less (OR=18.5; 95% CI, 2.05-167.79) were predictive of day hospital patients having a history of recurrent falls. CONCLUSIONS: OLST and B-POMA both have potential as screening tools for risk of falls, but this observation requires confirmation in a prospective study.