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Comparing the functional impact of knee replacements in two cohorts

BACKGROUND: To examine if different rates of total knee replacement (TKR) in two similar cohorts with symptomatic knee osteoarthritis (OA) were associated with different functional impact of disease. METHODS: Subjects from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative...

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Autores principales: Niu, Jingbo, Nevitt, Michael, McCulloch, Charles, Torner, James, Lewis, C Elizabeth, Katz, Jeffrey N, Felson, David T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4016673/
https://www.ncbi.nlm.nih.gov/pubmed/24885404
http://dx.doi.org/10.1186/1471-2474-15-145
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author Niu, Jingbo
Nevitt, Michael
McCulloch, Charles
Torner, James
Lewis, C Elizabeth
Katz, Jeffrey N
Felson, David T
author_facet Niu, Jingbo
Nevitt, Michael
McCulloch, Charles
Torner, James
Lewis, C Elizabeth
Katz, Jeffrey N
Felson, David T
author_sort Niu, Jingbo
collection PubMed
description BACKGROUND: To examine if different rates of total knee replacement (TKR) in two similar cohorts with symptomatic knee osteoarthritis (OA) were associated with different functional impact of disease. METHODS: Subjects from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), persons with or at high risk of OA, had knee radiographs, completed Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) surveys and had TKRs confirmed at each visit. At each visit, subjects were defined as having symptomatic OA (SxOA) if ≥ one knee had pain and radiographic OA or if they had a TKR. WOMAC function scores at each visit were compared by analysis of covariance adjusting for age, sex, body mass index, race, site, depression, comorbidity, painful leg joints and knees affected. Post-TKR function scores were imputed to estimate scores that would have been present without TKR. RESULTS: Subjects with SxOA (n > 750 in MOST and in OAI) had a mean age 66 to 67 years; most were women and were White. Subjects were followed 4–5 years. Among those with SxOA, more TKRs were done in MOST (35%) than OAI (19%). Adjusted mean WOMAC function (0–68, 68 = worst) improved from 26.9 to 21.9 in MOST and from 24.5 to 22.0 in OAI (difference between MOST and OAI in change in WOMAC function, p = .01). Estimates of function without TKRs showed function would not have changed in MOST (23.2 at baseline to 22.4). CONCLUSIONS: Functional status of subjects with knee OA in MOST improved more than in OAI, probably because of higher rates of TKRs. The decline suggests that TKR diminishes the functional impact of OA in the community.
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spelling pubmed-40166732014-05-11 Comparing the functional impact of knee replacements in two cohorts Niu, Jingbo Nevitt, Michael McCulloch, Charles Torner, James Lewis, C Elizabeth Katz, Jeffrey N Felson, David T BMC Musculoskelet Disord Research Article BACKGROUND: To examine if different rates of total knee replacement (TKR) in two similar cohorts with symptomatic knee osteoarthritis (OA) were associated with different functional impact of disease. METHODS: Subjects from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI), persons with or at high risk of OA, had knee radiographs, completed Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) surveys and had TKRs confirmed at each visit. At each visit, subjects were defined as having symptomatic OA (SxOA) if ≥ one knee had pain and radiographic OA or if they had a TKR. WOMAC function scores at each visit were compared by analysis of covariance adjusting for age, sex, body mass index, race, site, depression, comorbidity, painful leg joints and knees affected. Post-TKR function scores were imputed to estimate scores that would have been present without TKR. RESULTS: Subjects with SxOA (n > 750 in MOST and in OAI) had a mean age 66 to 67 years; most were women and were White. Subjects were followed 4–5 years. Among those with SxOA, more TKRs were done in MOST (35%) than OAI (19%). Adjusted mean WOMAC function (0–68, 68 = worst) improved from 26.9 to 21.9 in MOST and from 24.5 to 22.0 in OAI (difference between MOST and OAI in change in WOMAC function, p = .01). Estimates of function without TKRs showed function would not have changed in MOST (23.2 at baseline to 22.4). CONCLUSIONS: Functional status of subjects with knee OA in MOST improved more than in OAI, probably because of higher rates of TKRs. The decline suggests that TKR diminishes the functional impact of OA in the community. BioMed Central 2014-05-05 /pmc/articles/PMC4016673/ /pubmed/24885404 http://dx.doi.org/10.1186/1471-2474-15-145 Text en Copyright © 2014 Niu et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Niu, Jingbo
Nevitt, Michael
McCulloch, Charles
Torner, James
Lewis, C Elizabeth
Katz, Jeffrey N
Felson, David T
Comparing the functional impact of knee replacements in two cohorts
title Comparing the functional impact of knee replacements in two cohorts
title_full Comparing the functional impact of knee replacements in two cohorts
title_fullStr Comparing the functional impact of knee replacements in two cohorts
title_full_unstemmed Comparing the functional impact of knee replacements in two cohorts
title_short Comparing the functional impact of knee replacements in two cohorts
title_sort comparing the functional impact of knee replacements in two cohorts
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4016673/
https://www.ncbi.nlm.nih.gov/pubmed/24885404
http://dx.doi.org/10.1186/1471-2474-15-145
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