REC REF:  21/WM/0276

Active and recruiting

The outcome of knee and hip surgery is normally measured using clinical and radiological data, which is entirely dependent on the surgeon’s judgement. Not only might this be biased, but also the patient and surgeon concerns may differ. As such, recording the patient’s perceptions is promoted in general care, orthopaedics, and rheumatology.

In the UK, there is a national requirement to report on patient-reported outcome measures (PROMS) for all patients undergoing knee and hip replacement (Arden et al., 2011). The idea behind PROMS is to judge if surgery has worked by understanding whether the patient “feels” better.

In this study, patients who are about to have hip or knee replacement surgery will be asked to take part in the study. The purpose of the study is to understand patient expectations before hip or knee surgery and their experiences after hip and knee surgery. The study helps to develop a novel orthopaedics questionnaire to show a change in symptoms as a result of undergoing surgery.


The objective of this study is to develop a robust questionnaire that captures patients’ experiences before and after hip or knee surgery and overcomes the existing floor and ceiling effects associated with existing measures.

The secondary objective is to validate the Imperial Orthopaedic Score questionnaire, exploring both its validity (i.e., how does it compare to similar questionnaires such as the Oxford Hip Score and/or EQ-5D) and whether it predicts patient outcomes after surgery.


This validation study aims to describe the Imperial Orthopaedic Score amongst patients undergoing elective joint surgery of the hip or knee.

The overall objective of the study is to develop a robust questionnaire, the Imperial Orthopaedic Score (IOS), that captures patients’ experiences before and after hip or knee surgery. By exploring some of the measures most commonly and currently in use and summarising this research data, we present up-to-date information regarding the status of evidence-based methods for assessing knee and hip surgery outcomes.

Another aim is to validate this questionnaire, exploring both construct validity and criterion-related validity.