Assessment and reliability of the World Health Organisation quality of life (WHO QOL-BREF) questionnaire in total hip replacement patients

Kumar, Prasoon; Sen, Ramesh Kumar; Aggarwal, Sameer; Jindal, Karan; Rajnish, Rajesh Kumar

BACKGROUND: Total hip replacement (THR) is a standard procedure for diseased or damaged hips for which several functional scoring tools are available to evaluate the outcomes. Majority of these scores were devised in western countries and their cross-cultural compatibility is rarely demonstrated. The World Health Organisation quality of life (WHOQOL-BREF) questionnaire is one of the best known multilingual instruments for such assessment which has 4 domains. Its reliability has never been demonstrated for THR and the present study was conceptualised for the same. METHODS: THRs done over 6 years were followed up retrospectively. Revision THRs and hemiarthroplasties were excluded. All the cases were done by a single senior arthroplasty surgeon. Clinical examination was done and questionnaires for WHO QOL-BREF and Harris Hip scores were given to the patients. RESULTS: The number of patients included in the study was 96 with 115 operated hips. The average age of these patients was 41.40 years ranging from 17 to 80 years. There was strong male preponderance in our series of patients with 90 THRs. The mean score of domain 1 was 70.8 (SD 21.6), domain 2: 72.4 (SD 18.8), domain 3: 74.7 (SD 16.8) and domain 4: 75.4 (SD 14.8), which showed significant functional improvement post THR in domain 2 (P = 0.0001), domain 3 (P = 0.0010) and domain 4(P = 0.0001), when compared to scores of general healthy population. Similarly, the scores were significantly improved in all domains as compared to cohorts of post-operative acetabular and hip fractures. The score was found to be a reliable tool with Cronbach's alpha of 0.912 and strong correlation was present with the standard Harris hip scores (p = 0.000). CONCLUSION: WHO QOL is a potent tool to assess the quality of life in patients undergoing THR. It can be used as a single index of measurement and it is simple, reproducible and reliable.