Predictors of outcomes of total knee replacement surgery.
OBJECTIVE: To identify pre-operative predictors of patient-reported outcomes of primary total knee replacement (TKR) surgery. METHODS: The Elective Orthopaedic Centre database is a large prospective cohort of 1991 patients receiving primary TKR in south-west London from 2005 to 2008. The primary out...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2012
|
| _version_ | 1797104240443785216 |
|---|---|
| author | Judge, A Arden, N Cooper, C Kassim Javaid, M Carr, A Field, R Dieppe, P |
| author_facet | Judge, A Arden, N Cooper, C Kassim Javaid, M Carr, A Field, R Dieppe, P |
| author_sort | Judge, A |
| collection | OXFORD |
| description | OBJECTIVE: To identify pre-operative predictors of patient-reported outcomes of primary total knee replacement (TKR) surgery. METHODS: The Elective Orthopaedic Centre database is a large prospective cohort of 1991 patients receiving primary TKR in south-west London from 2005 to 2008. The primary outcome is the 6-month post-operative Oxford Knee Score (OKS). To classify whether patients had a clinically important outcome, we calculated a patient acceptable symptom state (PASS) for the 6-month OKS related to satisfaction with surgery. Potential predictor variables were pre-operative OKS, age, sex, BMI, deprivation, surgical side, diagnosis, operation type, American Society of Anesthesiologists grade and EQ5D anxiety/depression. Regression modelling was used to identify predictors of outcome. RESULTS: The strongest determinants of outcome include pre-operative pain/function-those with less severe pre-operative disease obtain the best outcomes; diagnosis in relation to pain outcome-patients with RA did better than those with OA; deprivation-those living in poorer areas had worse outcomes; and anxiety/depression-worse pre-operative anxiety/depression led to worse pain. Differences were observed between predictors of pain and functional outcomes. Diagnosis of RA and anxiety/depression were associated with pain, whereas age and gender were specifically associated with function. BMI was not a clinically important predictor of outcome. CONCLUSION: This study identified clinically important predictors of attained pain/function post-TKR. Predictors of pain were not necessarily the same as functional outcomes, which may be important in the context of a patient's expectations of surgery. Other predictive factors need to be identified to improve our ability to recognize patients at risk of poor TKR outcomes. |
| first_indexed | 2024-03-07T06:31:06Z |
| format | Journal article |
| id | oxford-uuid:f604a3b3-445e-4f37-af0c-188cfdb90489 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:31:06Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:f604a3b3-445e-4f37-af0c-188cfdb904892022-03-27T12:31:47ZPredictors of outcomes of total knee replacement surgery.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f604a3b3-445e-4f37-af0c-188cfdb90489EnglishSymplectic Elements at Oxford2012Judge, AArden, NCooper, CKassim Javaid, MCarr, AField, RDieppe, POBJECTIVE: To identify pre-operative predictors of patient-reported outcomes of primary total knee replacement (TKR) surgery. METHODS: The Elective Orthopaedic Centre database is a large prospective cohort of 1991 patients receiving primary TKR in south-west London from 2005 to 2008. The primary outcome is the 6-month post-operative Oxford Knee Score (OKS). To classify whether patients had a clinically important outcome, we calculated a patient acceptable symptom state (PASS) for the 6-month OKS related to satisfaction with surgery. Potential predictor variables were pre-operative OKS, age, sex, BMI, deprivation, surgical side, diagnosis, operation type, American Society of Anesthesiologists grade and EQ5D anxiety/depression. Regression modelling was used to identify predictors of outcome. RESULTS: The strongest determinants of outcome include pre-operative pain/function-those with less severe pre-operative disease obtain the best outcomes; diagnosis in relation to pain outcome-patients with RA did better than those with OA; deprivation-those living in poorer areas had worse outcomes; and anxiety/depression-worse pre-operative anxiety/depression led to worse pain. Differences were observed between predictors of pain and functional outcomes. Diagnosis of RA and anxiety/depression were associated with pain, whereas age and gender were specifically associated with function. BMI was not a clinically important predictor of outcome. CONCLUSION: This study identified clinically important predictors of attained pain/function post-TKR. Predictors of pain were not necessarily the same as functional outcomes, which may be important in the context of a patient's expectations of surgery. Other predictive factors need to be identified to improve our ability to recognize patients at risk of poor TKR outcomes. |
| spellingShingle | Judge, A Arden, N Cooper, C Kassim Javaid, M Carr, A Field, R Dieppe, P Predictors of outcomes of total knee replacement surgery. |
| title | Predictors of outcomes of total knee replacement surgery. |
| title_full | Predictors of outcomes of total knee replacement surgery. |
| title_fullStr | Predictors of outcomes of total knee replacement surgery. |
| title_full_unstemmed | Predictors of outcomes of total knee replacement surgery. |
| title_short | Predictors of outcomes of total knee replacement surgery. |
| title_sort | predictors of outcomes of total knee replacement surgery |
| work_keys_str_mv | AT judgea predictorsofoutcomesoftotalkneereplacementsurgery AT ardenn predictorsofoutcomesoftotalkneereplacementsurgery AT cooperc predictorsofoutcomesoftotalkneereplacementsurgery AT kassimjavaidm predictorsofoutcomesoftotalkneereplacementsurgery AT carra predictorsofoutcomesoftotalkneereplacementsurgery AT fieldr predictorsofoutcomesoftotalkneereplacementsurgery AT dieppep predictorsofoutcomesoftotalkneereplacementsurgery |