SAN DIEGO, March 10, 2025 /PRNewswire/ -- Living with osteoarthritis not only affects a person's quality of life but can greatly impact their spouse's quality of life. A new study found that spouses experience significant improvements in quality of life after their partner undergoes total hip or knee arthroplasty (THA, TKA). Presented at the American Academy of Orthopaedic Surgeons' (AAOS) 2025 Annual Meeting, it is among the first to demonstrate this positive impact.

Osteoarthritis is the most common type of arthritis, causing joint pain, stiffness and swelling and affecting 33 million adults in the United States.ⁱ As the cartilage at the end of the bones gradually wears away, it causes pain that can worsen over time. It mainly occurs in those who are middle age and older and may eventually lead to the need for hip or knee replacement.ⁱⁱ As the U.S. population grows, THA and TKA have become more common, with approximately 544,000 THAs and 790,000 TKAs taking place each year.ⁱⁱⁱ

The issues associated with osteoarthritis not only affect patients but also their spouses. With the rising number of hip and knee replacements, spouses have increasingly become the primary caregivers following surgery as total joint arthroplasty has moved to outpatient surgery, shifting the responsibility from the healthcare team to the patient's family.^iv,v,vi Studies have shown that spouses of those with chronic pain have a lower quality of life and higher levels of depression.^iv,v

"A lot of times what we see in clinical practice is it is the spouse that prompts the patient to seek care for a variety of reasons, such as not being able to do everyday activities," said Nicholas Michael Brown, MD, FAAOS, associate professor, Loyola Medicine in Chicago. "This study further validates the effectiveness of knee and hip replacements for patients' pain and well-being, as well as those around them. It confirms the transformational power of this surgery and the ways it benefits their spouses and families."

In a retrospective cohort study, the researchers surveyed 100 spouses of patients who underwent THA and TKA – 50 in the THA and 50 in the TKA groups – at a single urban tertiary academic medical center. The survey included six questions related to their caregiving burden, quality of life and physical function. It was completed at least one year after their spouse's surgery, with means of 1.9 and 2.2 years postoperatively for the THA and TKA groups, respectively.

Spouses were asked about assisting their partners who had hip and knee replacements on a one-to-five scale, with one meaning "never" and five meaning "always." At the preoperative, one to two weeks postoperative and at least one-year post-operative timepoints, spouse-reported assistance with everyday activities in the THA group were 2.58, 2.68 and 1.42, respectively. When spouses were surveyed about their own quality of life compared to before their spouse's surgery, 70% said their quality of life was slightly or significantly better, 28% noted no change and 2% reported a slightly worse quality of life. There were no reports of a significantly worse quality of life. Spouses also reported significant improvement in the patient's physical function and quality of life after THA.

The TKA group saw comparable results. In the one to two weeks following surgery, spouse-reported assistance with daily activities increased, but decreased at least one year after surgery compared to the preoperative mark. At the preoperative, one to two weeks postoperative and at least one-year post-operative time points, the means were 1.98, 3.74 and 1.84, respectively. Rating their quality of life, 76% of spouses said their quality of life was slightly better or significantly better after their significant other's TKA. Spouses also said the patient's physical function and quality of life improved following knee replacement.

"For surgeons, this study is an important piece of information they can use to counsel their patients and their spouses on what to expect after THA and TKA," said Lead Author Nicolas Jozefowski, BS, MS4, Stritch School of Medicine, Loyola University. "It is well studied that the patient's quality of life improves following surgery, but now we know it will also improve for spouses. Most spouses assume a caregiving role when their partner has joint replacement surgery and they are sacrificing a bit in terms of their quality of life, but we can show it will improve with these data. Patients can have less pain, and couples can do more things together after THA and TKA."

The study was limited in that it was retrospective, and spouses were asked to recall their opinions from before and immediately after the patient's surgery, which may introduce recall bias. Other health issues that may impact quality of life were not included.

2025 AAOS Annual Meeting Disclosure Statement

About the AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world's largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients daily. AAOS is the source of information on bone and joint conditions, treatments, and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality.

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ⁱ U.S. Centers for Disease Control and Prevention. Osteoarthritis. Published Jan. 26, 2024. Accessed Jan. 30, 2025. https://www.cdc.gov/arthritis/osteoarthritis/index.html
ⁱⁱ American Academy of Orthopaedic Surgeons. OrthoInfo. Osteoarthritis. Published April 2022. Accessed Jan. 30, 2025. https://orthoinfo.aaos.org/en/diseases--conditions/osteoarthritis/
ⁱⁱⁱ American College of Rheumatology. Joint Replacement Surgery. Published February 2024. Accessed Dec. 18, 2024. https://rheumatology.org/patients/joint-replacement-surgery
^iv Geisser ME, Cano A, Leonard MT. Factors associated with marital satisfaction and mood among spouses of persons with chronic back pain. J Pain. 2005;6(8):518-525.
^v Leonard MT, Cano A. Pain affects spouses too: personal experience with pain and catastrophizing as correlates of spouse distress. Pain. 2006;126(1-3):139-146.
^vi Stark ÅJ, Salanterä S, Sigurdardottir AK, Valkeapää K, Bachrach-Lindström M. Spouse-related factors associated with quality of recovery of patients after hip or knee replacement - a Nordic perspective. Int J Orthop Trauma Nurs. 2016;23:32-46.

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SOURCE American Academy of Orthopaedic Surgeons