Who Benefits From Joint Replacement?
Hawker GA, Badley EM, Borkhoff CM, et al
Arthritis Rheum. 2013;65:1243-1252
More than 1 million total joint arthroplasties (TJAs) are performed in the United States and Canada annually. Most studies report good outcomes after such surgeries; however, data from large-scale studies of a broad range of patients undergoing TJAs are relatively limited.
Hawker and colleagues evaluated the outcomes of TJA in 202 Canadian patients for whom pre- and post-TJA data were available (133 knee and 69 hip replacements) on procedures performed before 2011. They evaluated the relationship between numerous variables and an outcome of improved Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores post-TJA.
A "good" outcome was defined as a change in the WOMAC pain and function/disability scores of 20% or greater, and an absolute change in each of these scores of 10% or greater. Of importance, this outcome evaluated the patients' overall pain and disability scores and did not focus on scores only from the replaced joint; the rationale was that this provides a better estimate of the patients' overall well-being after TJA rather than just focusing on the specific symptoms in the replaced joint.
At the time of their TJA, the mean age of the patients was 71 years, and approximately 70% were women. Overall, 52% of patients with knee replacements and 57% of patients with hip replacements met the study's established criteria for a good outcome. Furthermore, the investigators found that the following factors were predictive of a good post-TJA outcome: high pre-TJA WOMAC score (indicating greater pain and disability), fewer comorbid conditions, osteoarthritis rather than inflammatory arthritis, and fewer other troublesome joint areas.
Which Patients Are Most Likely to Benefit From Total Joint Arthroplasty?
Hawker GA, Badley EM, Borkhoff CM, et al
Arthritis Rheum. 2013;65:1243-1252
Study Summary
More than 1 million total joint arthroplasties (TJAs) are performed in the United States and Canada annually. Most studies report good outcomes after such surgeries; however, data from large-scale studies of a broad range of patients undergoing TJAs are relatively limited.
Hawker and colleagues evaluated the outcomes of TJA in 202 Canadian patients for whom pre- and post-TJA data were available (133 knee and 69 hip replacements) on procedures performed before 2011. They evaluated the relationship between numerous variables and an outcome of improved Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores post-TJA.
A "good" outcome was defined as a change in the WOMAC pain and function/disability scores of 20% or greater, and an absolute change in each of these scores of 10% or greater. Of importance, this outcome evaluated the patients' overall pain and disability scores and did not focus on scores only from the replaced joint; the rationale was that this provides a better estimate of the patients' overall well-being after TJA rather than just focusing on the specific symptoms in the replaced joint.
At the time of their TJA, the mean age of the patients was 71 years, and approximately 70% were women. Overall, 52% of patients with knee replacements and 57% of patients with hip replacements met the study's established criteria for a good outcome. Furthermore, the investigators found that the following factors were predictive of a good post-TJA outcome: high pre-TJA WOMAC score (indicating greater pain and disability), fewer comorbid conditions, osteoarthritis rather than inflammatory arthritis, and fewer other troublesome joint areas.