RT Journal Article
SR Electronic
T1 Prevalence of Clinically Significant Improvement Following Total Knee Replacement
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 753
OP 759
DO 10.3899/jrheum.100233
VO 38
IS 4
A1 KHALID ALZAHRANI
A1 RAJIV GANDHI
A1 JUSTIN deBEER
A1 DANIELLE PETRUCCELLI
A1 NIZAR MAHOMED
YR 2011
UL http://www.jrheum.org/content/38/4/753.abstract
AB Objective. Although total knee replacement (TKR) has a high reported success rate, the pain relief and functional improvement after surgery vary. The purpose of our retrospective cohort study was to determine the prevalence of patients showing no clinically important improvement 1 year after TKR, and patient factors that may predict this outcome. Methods. We reviewed primary TKR registry data that were collected from 2 academic hospitals: the Toronto Western Hospital and the Hamilton Health Sciences Henderson Hospital in Ontario, Canada. Relevant covariates including demographic data, body mass index, and comorbidity were recorded. Knee joint pain and functional status were assessed at baseline and at 1-year followup with the Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Oxford Knee Score (OKS) to measure the change using the minimal clinically important difference (MCID). Logistic regression modeling was used to identify the predictors of interest. Results. Overall, 11.7% (373/3177) of patients reported no clinically important improvement 1 year after surgery. Logistic regression modeling showed that a greater patient age independently predicted no clinically important improvement on the WOMAC scale 1 year after surgery (p = 0.0003), while being male independently predicted no clinically important improvement on the OKS 1 year after surgery (p = 0.008). Conclusion. Awareness of the prevalence of patients who may show no clinically important improvement and factors that predict this outcome will help patients and surgeons set realistic expectations of surgery.