Dataset Information

The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement.

ABSTRACT:

Objective

To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA).

Methods

Design

International cross-sectional study in 10 countries.

Patients

Consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified.

Outcome measures

Pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome Score Physical function Short-form, 0-100).

Analyses

Comparison of patients with vs without surgeons' indication for TJR. Receiver Operating Characteristic (ROC) curve analyses and logistic regression were applied to determine cut points of pain and disability defining recommendation for TJR.

Results

In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 [standard deviation (SD) 10.9] years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes vs no) had worse symptom levels [pain, 55.5 (95% confidence interval 54.2, 56.8) vs. 44.9 (43.2, 46.6), and functional impairment, 59.8 (58.7, 60.9) vs. 50.9 (49.3, 52.4), respectively, both P<0.0001], there was substantial overlap in symptom levels between groups, even when adjusting for radiographic joint status. Thus, it was not possible to determine cut points for pain and function defining 'requirement for TJR'.

Conclusion

Although symptom levels were higher in patients recommended for TJR, pain and functional disability alone did not discriminate between those who were and were not considered to need TJR by the orthopaedic surgeon.

SUBMITTER: Gossec L

PROVIDER: S-EPMC4151518 | biostudies-literature | 2011 Feb

REPOSITORIES: biostudies-literature

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Publications

The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement.

Gossec L L Paternotte S S Maillefert J F JF Combescure C C Conaghan P G PG Davis A M AM Gunther K-P KP Hawker G G Hochberg M M Katz J N JN Kloppenburg M M Lim K K Lohmander L S LS Mahomed N N NN March L L Pavelka K K Punzi L L Roos E M EM Sanchez-Riera L L Singh J A JA Suarez-Almazor M E ME Dougados M M

Osteoarthritis and cartilage 20101031 2

<h4>Objective</h4>To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA).<h4>Methods</h4><h4>Design</h4>International cross-sectional study in 10 countries.<h4>Patients</h4>Consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified.<h4>Outcome measures</h4>Pain (ICOAP: int ...[more]

PMID: 21044689

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Dataset Information

The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement.

Objective

Methods

Design

Patients

Outcome measures

Analyses

Results

Conclusion

Publications

The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement.

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