SIGNIFICANCE: Occupational therapists routinely provide intervention for those undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA); however, researchers have used outcome measures inconsistently and have failed to measure occupational performance comprehensively. In this ongoing study, the norm-based Short Musculoskeletal Function Assessment (SMFA) was used to provide a comprehensive measure of outcome reflecting clinical change in mobility, arm and hand function, activities of daily living, and emotional status before and after THA and TKA.

INNOVATION: Completion of the SMFA prior to and after THA and TKA provided comparison of patient performance to norms as well as comprehensive measurement of occupational performance related to mobility, arm and hand function, activities of daily living, and emotional status after THA and TKA. Preliminary data show deficits across all categories, including arm and hand function, not previously documented.

APPROACH: In this study, we attempted to answer the following research question: What are the outcomes, as measured by the SMFA, for individuals after TKA and THA? Researchers have used outcome measures inconsistently and have focused primarily on outcomes related to lower extremity physical function after THA and TKA. Comprehensive assessment of occupational performance is needed with THA and TKA.

METHOD: The study is an ongoing, quantitative, repeated-measures design. We used de-identified retrospective data provided by the health care setting to measure SMFA outcomes. We partnered with an acute care, general medical, surgical hospital. Participants were patients scheduled for elective THA and TKA. SMFA outcome was used as a routine part of assessment procedures in occupational and physical therapy services. The SMFA was administered preoperatively; at 2 days after surgery; as well as 1, 2, and 3 mo after surgery. The design also includes future SMFA administration at 6 and 12 mo. Descriptive statistics were used to analyze the demographic data. Analysis of variance (ANOVA) was used to measure differences in SMFA scores between each of the time frames of data collection.

RESULTS: Preliminary results show that patients scheduled for THA and TKA have 2 to 3 times the disability preoperatively in categories of mobility, activities of daily living (ADLs), arm and hand function, and emotional status compared with population norms. Disability increases significantly in all categories except mobility 2 days after surgery. Disability scores decrease significantly in mobility, ADLs, arm and hand function, and emotional status 1 mo after surgery, with arm and hand function reaching population norms. Disability scores continue to decrease 2 and 3 mo after surgery, approaching but not reaching norms.

CONCLUSION: Individuals with TKA and THA experience disability greater than the normal population in mobility, ADLs, arm and hand function, and emotional status prior to surgery; these individuals approach population norms 2 to 3 mo after surgery. A limitation of this study is that the retrospective and descriptive design prevents identifying variables that influence clinical change.