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Living with osteoarthritis (OA) not only affects a person’s quality of life but can also greatly impact their spouse’s quality of life.

A new study presented at the American Academy of Orthopaedic Surgeons’ 2025 Annual Meeting found that spouses experience significant improvements in quality of life after their partner undergoes total hip (THA) or knee arthroplasty (TKA).

The study is among the first to demonstrate this positive impact.

Shifting Patient Care Responsibility

The rising number of  THAs and TKAs being performed coupled with the increasing push for outpatient surgery has shifted more responsibility for patient care from the healthcare team to the patient’s family, with spouses increasingly filling the role of primary caregiver  following surgery. [1-3] Studies have shown that spouses of those with chronic pain have a lower quality of life and higher levels of depression. [1,2]

“A lot of times what we see in clinical practice is [that] the spouse prompts the patient to seek care for a variety of reasons, such as not being able to do everyday activities,” said study author Nicholas M. Brown, MD, an associate professor at 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.”

Study Findings

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 6 questions related to their caregiving burden, quality of life, and physical function. It was completed at least 1 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 undergone THA or TKA on a 1- to 5-point scale, with 1 meaning “never” and 5 meaning “always.” At 3 time points – preoperative, 1 to 2 weeks postoperative, and at least 1 year postoperative – scores for spouse-reported assistance with everyday activities in the THA group were 2.58, 2.68, and 1.42, respectively. Comparable results were reported in the TKA group: 1.98, 3.74, and 1.84, respectively.

When spouses in the THA group 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.

In the TKA group, 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.

Counseling Patients and Spouses

“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 study author  Nicolas Jozefowski, BS, MS4, from Stritch School of Medicine at 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.

References

1. 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.
2. 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.
3. 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.

Source

Jozefowski N, Farly JM, Cole MW, Haughom B, Schmitt D, Brown NM. Spouses of total hip and knee arthroplasty patients see improvements in quality of life. Presented at the 2025 Annual Meeting of the American Academy of Orthopaedic Surgeons, March 10-14, 2025, in San Diego, California.