RT Journal Article
SR Electronic
T1 Presurgery osteoarthritis severity over 10 years in 2 Ontario prospective total knee replacement cohorts: a cohort study
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E269
OP E275
DO 10.9778/cmajo.20170164
VO 6
IS 3
A1 Aileen M. Davis
A1 Selahadin Ibrahim
A1 Sheilah Hogg-Johnson
A1 Dorcas E. Beaton
A1 Bert M. Chesworth
A1 Rajiv Gandhi
A1 Nizar N. Mahomed
A1 Anthony V. Perruccio
A1 Vaishnav Rajgopal
A1 Rosalind Wong
A1 James P. Waddell
YR 2018
UL http://www.cmajopen.ca/content/6/3/E269.abstract
AB Background: It has been suggested that total knee replacement is being performed in people with less-severe osteoarthritis. We aimed to determine whether there were differences in the presurgery profile, symptoms and disability of 2 cohorts who underwent total knee replacement over a 10-year period.Methods: Patients aged 18–85 years undergoing primary total knee replacement for osteoarthritis at 1 of 4 sites in Toronto and Strathroy, Ontario, were recruited in a cohort study during 2006–2008 (cohort 1) and 2012–2015 (cohort 2). Patients undergoing unicompartmental or revision arthroplasty were excluded. Demographic and health (body mass index [BMI], comorbidity) variables and osteoarthritis severity, as assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the disability component of the Late-Life Function and Disability Instrument (LLFDI-D), were collected before surgery. We calculated proportions, means and standard deviations with 95% confidence intervals (CIs) for all data. We constructed density plots by tertile score for the WOMAC pain and physical function subscales and the LLFDI-D limitation scale.Results: There were 494 patients in cohort 1 and 251 patients in cohort 2. There were no differences in age, sex, education, living status, BMI, comorbidity, pain severity or disability between the cohorts based on overlapping 95% CIs and the density plots. More patients in cohort 1 than in cohort 2 were single (176 [35.6%], 95% CI 32.5%–41.1% v. 63 [25.1%], 95% CI 20.3%–31.0%). Patients in cohort 2 reported less limitation in higher-demand activities than did those in cohort 1 (mean score on LLFDI-D 62.3 [95% CI 60.7–63.9] v. 59.2 [95% CI 58.2–60.2]).Interpretation: The patient profile and reported osteoarthritis severity were similar in 2 cohorts that had total knee replacement over a 10-year period. This suggests that increasing total knee replacement volumes over this period likely were not driven by these factors.