We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes.
- Authors
Singh, Jasvinder A.; Lewallen, David G.
- Abstract
Background: To examine whether function and pain outcomes of patients undergoing primary total knee arthroplasty (TKA) are changing over time. Methods: The Mayo Clinic Total Joint Registry provided data for time-trends in preoperative and 2-year post-operative activity limitation and pain in primary TKA patients from 1993-2005. We used chi-square test and analysis for variance, as appropriate. Multivariable-adjusted analyses were done using logistic regression. Results In a cohort of 7,229 patients who underwent primary TKA during 1993-2005, mean age was 68.4 years (standard deviation (SD), 9.8), mean BMI was 31.1 (SD, 6.0) and 55% were women. Crude estimates showed that preoperative moderate-severe overall limitation were seen in 7.3% fewer patients and preoperative moderate-severe pain in 2.7% more patients in 2002-05, compared to 1992-95 (p < 0.001 for both). At 2-years, crude estimates indicated that compared to 1992-95, moderate-severe post-TKA overall limitation was seen in 4.7% more patients and moderate-severe post-TKA pain in 3.6% more patients in 2002-05, both statistically significant (p ≤ 0.018) and clinically meaningful. In multivariable-adjusted analyses that adjusted for age, sex, anxiety, depression, Deyo-Charlson index, body mass index and preoperative pain/limitation, patients had worse outcomes 2-year post-TKA in 2002-2005 compared to 1993-95 with an odds ratio (95% confidence interval (CI); p-value) of 1.34 (95% CI: 1.02, 1.76, p = 0.037) for moderate-severe activity limitation and 1.79 (95% CI: 1.17, 2.75, p = 0.007) for moderate-severe pain. Conclusion: Patient-reported function and pain outcomes after primary TKA have worsened over the study period 1993-95 to 2002-05. This time-trend is independent of changes in preoperative pain/limitation and certain patient characteristics.
- Subjects
TOTAL knee replacement; PAIN perception; ANALYSIS of variance; PREOPERATIVE care; BODY mass index; SEX factors in disease
- Publication
BMC Musculoskeletal Disorders, 2014, Vol 15, Issue 1, p622
- ISSN
1471-2474
- Publication type
Article
- DOI
10.1186/1471-2474-15-440