Comparing the functional impact of knee replacements in two cohorts

Jingbo Niu; Michael Nevitt; Charles McCulloch; James Torner; C Elizabeth Lewis; Jeffrey N Katz; David T Felson; Multicenter Osteoarthritis Study Group

doi:10.1186/1471-2474-15-145

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Comparing the functional impact of knee replacements in two cohorts

Journal article

Open access

Peer reviewed

Comparing the functional impact of knee replacements in two cohorts

Jingbo Niu, Michael Nevitt, Charles McCulloch, James Torner, C Elizabeth Lewis, Jeffrey N Katz, David T Felson and Multicenter Osteoarthritis Study Group

BMC musculoskeletal disorders, Vol.15(1), pp.145-145

05/05/2014

DOI: 10.1186/1471-2474-15-145

PMCID: PMC4016673

PMID: 24885404

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Abstract

To examine if different rates of total knee replacement (TKR) in two similar cohorts with symptomatic knee osteoarthritis (OA) were associated with different functional impact of disease. Subjects from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), persons with or at high risk of OA, had knee radiographs, completed Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) surveys and had TKRs confirmed at each visit. At each visit, subjects were defined as having symptomatic OA (SxOA) if ≥ one knee had pain and radiographic OA or if they had a TKR. WOMAC function scores at each visit were compared by analysis of covariance adjusting for age, sex, body mass index, race, site, depression, comorbidity, painful leg joints and knees affected. Post-TKR function scores were imputed to estimate scores that would have been present without TKR. Subjects with SxOA (n>750 in MOST and in OAI) had a mean age 66 to 67 years; most were women and were White. Subjects were followed 4-5 years. Among those with SxOA, more TKRs were done in MOST (35%) than OAI (19%). Adjusted mean WOMAC function (0-68, 68 = worst) improved from 26.9 to 21.9 in MOST and from 24.5 to 22.0 in OAI (difference between MOST and OAI in change in WOMAC function, p = .01). Estimates of function without TKRs showed function would not have changed in MOST (23.2 at baseline to 22.4). Functional status of subjects with knee OA in MOST improved more than in OAI, probably because of higher rates of TKRs. The decline suggests that TKR diminishes the functional impact of OA in the community.

Arthroplasty, Replacement, Knee - trends

Follow-Up Studies

Humans

Middle Aged

Osteoarthritis, Knee - diagnosis

Recovery of Function - physiology

Female

Male

Aged

Osteoarthritis, Knee - physiopathology

Osteoarthritis, Knee - surgery

Cohort Studies

Details

Title: Subtitle: Comparing the functional impact of knee replacements in two cohorts
Creators: Jingbo Niu
Michael Nevitt
Charles McCulloch
James Torner
C Elizabeth Lewis
Jeffrey N Katz
David T Felson - From the Clinical Epidemiology Unit, Boston University School of Medicine, 650 Albany Street, Suite X200, Boston, MA 02118, USA. dfelson@bu.edu
Multicenter Osteoarthritis Study Group
Resource Type: Journal article
Publication Details: BMC musculoskeletal disorders, Vol.15(1), pp.145-145
DOI: 10.1186/1471-2474-15-145
PMID: 24885404
PMCID: PMC4016673
NLM abbreviation: BMC Musculoskelet Disord
ISSN: 1471-2474
eISSN: 1471-2474
Publisher: England
Grant note: U01 AG018947 / NIA NIH HHS U01 AG018832 / NIA NIH HHS AR47785 / NIAMS NIH HHS U01 AG18947 / NIA NIH HHS U01 AG18832 / NIA NIH HHS U01 AG019069 / NIA NIH HHS AR051568 / NIAMS NIH HHS U01 AG18820 / NIA NIH HHS P60 AR047785 / NIAMS NIH HHS U01 AG19069 / NIA NIH HHS U01 AG018820 / NIA NIH HHS
Language: English
Date published: 05/05/2014
Academic Unit: Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9983996087702771

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