Study Design
Knee Injury, Osteoarthritis
SECONDARY, OSTEOARTHRITIS
A 2-group, parallel patient-level randomized clinical trial, PROMoting Quality, was conducted across 9 German hospitals to assess a PROM-based monitoring intervention for patients with hip replacement or knee replacement. This study presents an a priori–specified analysis of the secondary outcomes. Patients were blinded to group assignment and group allocation sequence, which was digitally initiated at discharge (individual randomization) and concealed from patients, study nurses, and physicians. The study was conducted in line with the published study protocolPatients digitally received the German language versions of (1) the Hip Disability and Osteoarthritis Outcome Score–Physical Function Shortform (HOOS-PS) and Knee Injury and Osteoarthritis Outcome Score–Physical Function Shortform (KOOS-PS) to measure physical functioning, scored from 0 to 100, with lower values indicating lower physical impairmentAll PROMs are validated in German, and most PROMs are validated specifically for patients with hip replacement or knee replacement.The control group received PROMs before surgery (between admission to the hospital and surgery), at discharge, and 12 months after surgery, whereas the intervention group additionally received PROMs at 1, 3, and 6 months after surgery (step 1). Automated digital alerts signaled critical recovery paths to hospital study nurses at 1, 3, and 6 months after surgery via a digital notification in the study software of their work computer (step 2).