Meet Dave. Dave is his real name and he is happy to share his story with you.
Dave is a 50 year old keen longtime runner enjoying 50-80 km a week. He started experiencing groin pain after his runs, then during his runs.
Despite good adherence to a physiotherapy strengthening program, Dave’s hip got progressively worse. He was no longer able to run comfortably. He started waking at night with pain, taking anti-inflammatories regularly. At 74 kgs, weight loss was not going to be a game-changer for him.
Dave tracked his hip OA using PROMs – in this case, a HAGOS (Copenhagen Hip and Groin Outcome Score).
The results show a progressive deterioration over 12 months.
Sub-scale scores of ‘participation in physical activity’, ‘sports and recreation’, and ‘hip related quality of life’ were each low. (Note that pain, symptoms and ADLs were not impaired as much)
The decision was made to proceed with surgical intervention. In Dave’s case, hip resurfacing, which is a procedure that involves replacing the femoral head surface with a metal cap and replacing the acetabular side with a prosthesis similar to that used in full hip replacement. It is not very common but is often performed in younger patients where there is a likelihood of needing revision surgery. Resurfacing preserves femoral “bone stock” making the subsequent total hip replacement down the track a bit easier to perform.
Pretty easy to see when Dave had his surgery!
We can see the survey evidence of his dramatic improvement. He was back running, now sticking to 7 km twice a week and throwing in some cycling for good measure.
In conditions that tend to be chronic, like OA, it’s really helpful for both patients and practitioners to have some qualitative way to track progress, good or bad.
Patient reported measures like PROMs can be added to objective measures like strength and range of motion to round out the patient’s status. PROMs can also be used to monitor a patient’s chronic condition remotely, keep them connected and giving you the opportunity to reach out and check in with how they are going.