PMID- 21239743
OWN - NLM
STAT- MEDLINE
DCOM- 20110720
LR  - 20220408
IS  - 1499-2752 (Electronic)
IS  - 0315-162X (Linking)
VI  - 38
IP  - 4
DP  - 2011 Apr
TI  - Prevalence of clinically significant improvement following total knee 
      replacement.
PG  - 753-9
LID - 10.3899/jrheum.100233 [doi]
AB  - OBJECTIVE: Although total knee replacement (TKR) has a high reported success 
      rate, the pain relief and functional improvement after surgery vary. The purpose 
      of our retrospective cohort study was to determine the prevalence of patients 
      showing no clinically important improvement 1 year after TKR, and patient factors 
      that may predict this outcome. METHODS: We reviewed primary TKR registry data 
      that were collected from 2 academic hospitals: the Toronto Western Hospital and 
      the Hamilton Health Sciences Henderson Hospital in Ontario, Canada. Relevant 
      covariates including demographic data, body mass index, and comorbidity were 
      recorded. Knee joint pain and functional status were assessed at baseline and at 
      1-year followup with the Western Ontario McMaster University Osteoarthritis Index 
      (WOMAC) and Oxford Knee Score (OKS) to measure the change using the minimal 
      clinically important difference (MCID). Logistic regression modeling was used to 
      identify the predictors of interest. RESULTS: Overall, 11.7% (373/3177) of 
      patients reported no clinically important improvement 1 year after surgery. 
      Logistic regression modeling showed that a greater patient age independently 
      predicted no clinically important improvement on the WOMAC scale 1 year after 
      surgery (p = 0.0003), while being male independently predicted no clinically 
      important improvement on the OKS 1 year after surgery (p = 0.008). CONCLUSION: 
      Awareness of the prevalence of patients who may show no clinically important 
      improvement and factors that predict this outcome will help patients and surgeons 
      set realistic expectations of surgery.
FAU - Alzahrani, Khalid
AU  - Alzahrani K
AD  - Division of Orthopedic Surgery, Toronto Western Hospital, Toronto, Ontario M5T 
      2S8, Canada.
FAU - Gandhi, Rajiv
AU  - Gandhi R
FAU - Debeer, Justin
AU  - Debeer J
FAU - Petruccelli, Danielle
AU  - Petruccelli D
FAU - Mahomed, Nizar
AU  - Mahomed N
LA  - eng
PT  - Journal Article
DEP - 20110115
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
SB  - IM
MH  - Aged
MH  - Arthroplasty, Replacement, Knee/*rehabilitation
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Ontario
MH  - Osteoarthritis, Knee/rehabilitation/*surgery
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - *Treatment Outcome
EDAT- 2011/01/18 06:00
MHDA- 2011/07/21 06:00
CRDT- 2011/01/18 06:00
PHST- 2011/01/18 06:00 [entrez]
PHST- 2011/01/18 06:00 [pubmed]
PHST- 2011/07/21 06:00 [medline]
AID - jrheum.100233 [pii]
AID - 10.3899/jrheum.100233 [doi]
PST - ppublish
SO  - J Rheumatol. 2011 Apr;38(4):753-9. doi: 10.3899/jrheum.100233. Epub 2011 Jan 15.