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Comparing the functional impact of knee replacements in two cohorts.

Niu, Jingbo; Nevitt, Michael; McCulloch, Charles; Torner, James; Lewis, C Elizabeth; Katz, Jeffrey N; Felson, David T

BMC musculoskeletal disorders. 2014;15:145.

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Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

Bibliographic metadata

Type of resource:
Content type:
Publication status:
Published
Publication type:
Published date:
Language:
eng
Abbreviated journal title:
ISSN:
Place of publication:
England
Volume:
15
Pagination:
145
Digital Object Identifier:
10.1186/1471-2474-15-145
Pubmed Identifier:
24885404
Pii Identifier:
1471-2474-15-145
Attached files embargo period:
Immediate release
Attached files release date:
1st July, 2014
Access state:
Active

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Academic department(s):

Record metadata

Manchester eScholar ID:
uk-ac-man-scw:228209
Created by:
Ingram, Mary
Created:
1st July, 2014, 09:57:14
Last modified by:
Ingram, Mary
Last modified:
1st July, 2014, 10:01:39

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