The establishment of an automated, electronic data-collection system for the purpose of qualifying, evaluating and improving post-operative surgical outcomes and evidence-based surgery

Abstract

It is an important goal to differentiate normal, age-related changes in joint function from changes associated with symptomatic pathology, surgical intervention or implant wear, fatigue or failure. A significant step toward this goal is the establishment of a joint-specific Patient Recorded Outcome Measures (PROM) reference database for individuals without joint disease, so that clinicians can effectively evaluate the efficacy of treatments in orthopaedic patients on a longitudinal basis. This thesis has investigated the influence of a range of factors on reported PROM values. Factors assessed were age, gender, ethnicity, handedness (where applicable), nationality, history of previous surgery and coincident adjacent active joint pathology. No other research exists comparing multiple PROMs over multiple body regions within an electronic database across two continents. This thesis of 2360 participants represents the largest database reported in the literature of orthopaedic PROM values from asymptomatic “normal” individuals. No other study has collated “normal” PROM values from multiple body regions. Nor have previous studies collected PROM scores remotely and electronically via the same research database, across two continents. Few studies have approached the numbers collected in this study. The PROMs investigated cover the four major joints, for which the majority of literature exists (hip, knee, shoulder & hand/wrist). The collected data has established a database of PROM population reference values for individuals who identify themselves as asymptomatic for the body parts under investigation. It is intended that these pooled values can be used as asymptomatic control cohorts for future studies investigating pathological cohorts.