Dataset Information

The use of biologic DMARDs identifies rheumatoid arthritis patients with more optimistic expectations of total knee arthroplasty.

ABSTRACT:

Background

Preoperative expectations of total knee arthroplasty (TKA) correlate with postsurgical satisfaction, and are linked to outcomes. Rheumatoid arthritis (RA), and other chronic diseases, may lower expectations, although new biologic medications have greatly enhanced patients' quality of life.

Questions/purposes

The purpose of this study is to compare preoperative expectations of RA to those of matched osteoarthritis (OA) patients undergoing TKA, and examine the subset of RA on biologic DMARD therapy.

Methods

For a cross-sectional study, RA and OA identified from an institutional TKA registry were matched on age, sex, prior TKA, and preoperative function. Expectations were measured using the Hospital for Special Surgery (HSS) Knee Expectations Survey. Expectations and quality of life measures were assessed preoperatively and scores were compared between RA and OA.

Results

One hundred fourteen RA cases, 46.5% on biologics, were matched to 228 OA cases. The average expectations score was not significantly lower for RA compared to OA (72.9?±?20.7 vs. 77.2?±?18.3, p?=?0.040. RA on biologics had expectations similar to OA (total expectation score 76.3?±?18.1 vs. 77.4?±?17.4, p?=?0.71), while RA not on biologics had expectations that were significantly lower (69.9?±?22.4 vs. 77.1?±?19.0, p?=?0.03).

Conclusion

Use of biologics in RA patients was associated with higher expectations, similar to those of OA patients, but the effect on outcomes is not known. Further studies should assess the effect of higher expectations in RA patients on outcomes.

SUBMITTER: Goodman SM

PROVIDER: S-EPMC4071470 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Publications

The use of biologic DMARDs identifies rheumatoid arthritis patients with more optimistic expectations of total knee arthroplasty.

Goodman Susan M SM Mandl Lisa A LA Figgie Mark M Johnson Beverly K BK Alexiades Michael M Ghomrawi Hassan H

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20140219 2

<h4>Background</h4>Preoperative expectations of total knee arthroplasty (TKA) correlate with postsurgical satisfaction, and are linked to outcomes. Rheumatoid arthritis (RA), and other chronic diseases, may lower expectations, although new biologic medications have greatly enhanced patients' quality of life.<h4>Questions/purposes</h4>The purpose of this study is to compare preoperative expectations of RA to those of matched osteoarthritis (OA) patients undergoing TKA, and examine the subset of R ...[more]

PMID: 25050094

Similar Datasets

Project description:IntroductionThe objective of this study was to assess the number and magnitude of preoperative expectations and to correlate them with the degree of satisfaction expressed one year after Total Hip Arthroplasty (THA) or Total Knee Arthroplasty (TKA), in patients with severe and painful osteoarthritis (OA).Materials and methodsPreoperative expectations (within 20 days prior to surgery) and postoperative satisfaction (one year after the intervention) were measured using the previously validated French version of the Hospital for Special Surgery Hip or Knee Replacement Expectations Survey. Postoperative satisfaction was measured using a specific scale, following the same methodology as that used for the assessment of expectations. Prediction of the satisfaction of the patients was performed using multivariate linear regression modelling.ResultsA total of 138 patients (80 THA and 58 TKA) completed the two parts of the study. The expectations score (mean ± SD) (range 0-100) was 72.58 ± 12.63 before THA and 69.10 ± 13.72 before TKA (p = 0.13). The number of expectations expressed was 14.34 ± 1.32 (out of a potential maximum of 18) before THA and 14.70 ± 2.29 (out of a potential maximum of 19) before TKA. After 1 year, THA generated a significantly higher degree of satisfaction compared to TKA (69.70 ± 14.46 v 60.44 ± 17.54, p<0.001) (range 0-100). The pre-operative expectations score was the single best positive predictor of the post-surgery satisfaction assessment both for TKA and THA.ConclusionPatients undergoing total joint arthroplasty for end-stage OA have a high level of expectations, before both THA and TKA. While both types of interventions significantly improve essential and non-essential activities, the rate of satisfaction is significantly greater post THA. Preoperative expectations are a major contributor to the final degree of satisfaction, one year after surgery. These results re-emphasize the need for an optimal preoperative interaction between health care providers and patients, to allow patients a chance to foresee a reasonable outcome after TJA.

Dataset Information

The use of biologic DMARDs identifies rheumatoid arthritis patients with more optimistic expectations of total knee arthroplasty.

Background

Questions/purposes

Methods

Results

Conclusion

Publications

The use of biologic DMARDs identifies rheumatoid arthritis patients with more optimistic expectations of total knee arthroplasty.

Similar Datasets

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