Introduction: In Australia, the majority of total knee and hip replacement surgeries occur in the private sector. Outcome‐based research needs to be inclusive of this sector if the findings are intended to reflect the broader picture. This study compares outcomes up to 1 year post knee and hip replacement between patients treated in the public and private sectors.
Methods: A prospective, observational study was performed in four high‐volume joint replacement centres: two public, two private. Experienced orthopaedic surgeons contributed via their public and private practices. Knee and hip patients were recruited preoperatively. Self‐reported questionnaires were completed preoperatively and at 6 and 12 months post‐operatively. The primary outcome was satisfaction with surgery. Secondary outcomes included Oxford score, and SF‐36 physical and mental component summary scores. Regression modelling was performed to adjust for potential confounders.
Results: Three hundred and thirty‐one patients (184 public, 147 private; 215 knees, 116 hips) were recruited, with 6‐ and 12‐month follow‐up rates of 95% and 89%, respectively. Satisfaction rates were high in both public and private patients (approximately 90%) at 6 and 12 months, but private patients were less likely to be satisfied after adjusting for the strong effect of patient expectation. For both hip and knee cohorts, no between‐sector differences were found in either the magnitude or rate of improvement in Oxford score or quality of life post‐operatively.
Discussion: Joint replacement outcomes are similar for patients treated in public and private hospitals. Surgeons should manage patient expectation prior to surgery, particularly in private patients.