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The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index is a disease-specific, self-administered, health status measure. It probes clinically-important symptoms in the areas of pain, stiffness and physical function in patients with osteoarthritis of the hip and/or knee. The index consists of 24 questions (5 pain, 2 stiffness and 17 physical function) and can be completed in less than 5 minutes. The WOMAC is a valid, reliable and sensitive instrument for the detection of clinically important changes in health status following a variety of interventions (pharmacologic, surgical, physiotherapy, etc.).

In The Hip & Knee Registry, WOMAC results are reported as a normalized score. Individual question responses are assigned a score of between 0 (extreme) and 4 (None). Individual question scores are then summed to form a raw score ranging from 0 (worst) to 96 (best). Finally, raw scores are normalized by multiplying each score by 100/96. This produces a reported WOMAC Score of between 0 (worst) to 100 (best).

As of December 1996, 2124 THA patients participating in The Hip & Knee Registry had a mean preoperative WOMAC score of 44. This improved to 74 at 1 to 5 months and to 78 at 5 to 18 months after THA.

Interpretation of the significance of differences in mean WOMAC scores is largely determined by sample size and the size of the difference in scores between groups of patients. Any formal test of statistical significance of differences in WOMAC scores should include the advice of a statistician.

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