Dataset Information

Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registry.

ABSTRACT:

Introduction

To study the use of pain medications for persistent index knee pain and their predictors after primary Total Knee Arthroplasty (TKA).

Methods

The Mayo Total Joint Registry collects patient-reported data including pain medication use on all patients who undergo TKA. We used data from patients who underwent primary TKA from 1993-2005. We examined whether gender, age (reference, ? 60 yrs), body mass index (BMI; reference, <25 kg/m2), comorbidities measured by Deyo-Charlson index (5-point increase), anxiety and depression predicted use of pain medications (non-steroidal anti-inflammatory drugs (NSAIDs) and opioids) 2- and 5-years after primary TKA. Multivariable logistic regression additionally adjusted for operative diagnosis, American Society of Anesthesiologists (ASA) score, implant fixation and distance from the medical center.

Results

7,139 of the 10,957 eligible (65%) at 2-years and 4,234 of 7,404 eligible (57%) completed questionnaires. Significant predictors of NSAIDs use were (Odds ratio (95% confidence interval)): male gender at 2- and 5-years, 0.5 (0.4, 0.6) and 0.6 (0.5, 0.8); age >70-80 years, 0.7 (0.5, 0.9), 0.6 (0.4, 0.8); and depression, 1.4 (1.0, 1.8) and 1.7 (1.1, 2.5). BMI ? 40 was associated with NSAIDs use only at 2-years, 1.6 (1.1, 2.5). Significant predictors of opioid pain medication use at 2- and 5-years were: male gender, 0.5 (0.3, 0.9) and 0.4 (0.2, 0.8); age >70-80 years, 0.3 (0.1, 0.6), 0.3 (0.1, 0.8); and anxiety, 3.0 (1.6, 5.7) and 4.0 (1.7, 9.4).

Conclusions

Female gender and younger age were associated with higher risk of use of NSAIDs and opioids after primary TKA. Depression was associated with higher NSAID use and anxiety with higher opioid pain medication use after primary TKA.

SUBMITTER: Singh JA

PROVIDER: S-EPMC3674590 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Publications

Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registry.

Singh Jasvinder A JA Lewallen David G DG

Arthritis research & therapy 20121116 6

<h4>Introduction</h4>To study the use of pain medications for persistent index knee pain and their predictors after primary Total Knee Arthroplasty (TKA).<h4>Methods</h4>The Mayo Total Joint Registry collects patient-reported data including pain medication use on all patients who undergo TKA. We used data from patients who underwent primary TKA from 1993-2005. We examined whether gender, age (reference, ≤ 60 yrs), body mass index (BMI; reference, <25 kg/m2), comorbidities measured by Deyo-Charls ...[more]

PMID: 23157942

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Project description:BackgroundAlthough total knee arthroplasty improves functional mobility in persons with end-stage knee osteoarthritis, many subjects have reported continued difficulty with stair ascent and descent after surgery. The purpose of the present study was to determine preoperative predictors of handrail use during stair ascent and descent following primary unilateral total knee arthroplasty.MethodsOne hundred and five adults who were scheduled for unilateral total knee arthroplasty participated in the study. Postoperative handrail use during stair ascent or descent was predicted on the basis of preoperative functional measures. Preoperative age, body mass index, knee strength, knee flexion active range of motion, Knee Outcome Survey scores, time to complete a stair-climbing task, and previous handrail use were entered as covariates into a binary logistic regression. Forward logistic regression was performed to determine which preoperative factors best predicted handrail use at three months and two years after surgery. Handrail use in a control group was also evaluated at baseline and at the time of the two-year follow-up.ResultsPrior to surgery, sixty-three of the 105 subjects required a handrail. Two years after surgery, sixty of the 105 subjects required a handrail. In the control group, nineteen of the sixty-four subjects required a handrail at baseline and ten of thirty-one required a handrail at the time of the two-year follow-up. At two years, the preoperative ability to ascend and descend stairs without a handrail was the best predictor of individuals who would not require a handrail after surgery, followed by younger age and greater quadriceps strength. Collectively, these variables correctly predicted the ability of ninety of 105 persons to negotiate stairs without a handrail at two years after surgery (p < 0.001).ConclusionsYounger, stronger patients who do not use a handrail prior to unilateral total knee arthroplasty can expect the best outcomes in terms of ascending and descending stairs following surgery. This information may provide patients with more realistic expectations after surgery and allow them to make more appropriate discharge plans.

Dataset Information

Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registry.

Introduction

Methods

Results

Conclusions

Publications

Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registry.

Similar Datasets

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