The questionnaire was divided into three sections: general demographic, ‘hip’ and ‘knee’. The hip section began with a screening question identical to other studies:7-10 ‘During the past 12 months, have you had pain in or around either of your hips on most days for one month or longer?’. Items concerning which hip was symptomatic and details of any previous hip replacement surgery followed, with standard response categories offered separately for the left and right hips.
How this fits in
In the UK, severe knee pain is more prevalent than hip pain among elderly people, yet considerably more hips are surgically replaced than knees. Variations in the treatment of hips and knees may exist, but there is no single explanation for the differential rate of arthroplasty. Hip replacement surgery is generally viewed as successful by people with hip pain, while people with knee pain appear less certain about the success of knee replacement operations. Such attitudes appear to be influenced by knowing someone who has undergone such surgery; thus, attitudes are likely to change as knee replacement becomes more common.
Additional questions were asked of people who reported having a symptomatic hip in the last year (‘hip cases’), with symptom severity for the right hip and left hip assessed separately. Severity during the past 4 weeks was assessed using the Lequesne functional index,11 a composite measurement score that ranges from 1 to 24 points and is based on 11 items concerned with mobility, pain, discomfort and the ability to function. Pain severity during the past 4 weeks was assessed separately using a scale ranging from ‘none’ to ‘very severe’. Information regarding the presence of serious comorbidity was asked: ‘Do you currently have another health problem that is at least as bad as the problem with your hip?’. Remaining questions focused on health service utilisation for the hip problem and attitudes towards total hip replacement surgery.
The knee section of the questionnaire was identical to the format of the hip section, with the word ‘knee’ substituted for the word ‘hip’. Patient consent for obtaining information from their GP was sought from those reporting hip or knee pain, and where consent was given, GPs were asked if they had knowledge of the hip or knee problem, and if the problem was due to primary or secondary OA.
