Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty

Razak, Hamid Rahmatullah Bin Abd; Tan, Chuen Seng; Chen, Jerry; Pang, Hee Nee; Tay, Kae Sian; Chin, Pak Lin; Chia, Shi‐Lu; Lo, Ngai-Nung; Yeo, Seng-Jin

doi:10.2106/jbjs.15.00280

Cited by 85 publications

(79 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No significant differences were seen between responders and non‐responders in the majority of demographic and clinical factors considered, including sex, BMI, diabetes, joint replaced, type of prosthesis used, and surgeons. Our results were consistent with previous reports . However, previous studies have also found higher age, sex, higher BMI, comorbidities, and joint replacement to be predictors of non‐responders using various PROMs, including the Oxford Knee Score, Short Form 36, EQ‐5D health questionnaire, and WOMAC .…”

Section: Discussionsupporting

confidence: 93%

“…However, the predictive power of these associations varies between studies; while Judge et al reported female sex was a predictor of function non‐response to THR, Weber et al reported male sex was a predictor of pain and function non‐response to both TKR and THR . Similar inconsistencies are seen with other commonly reported variables including age, BMI, comorbidities, pre‐operative pain scores, and pre‐operative function scores . The lack of consistency could be attributed to a number of factors within these studies, including variation in the definition of the MCID, type of joint replacement, and distinction between pain and function in outcome.…”

mentioning

confidence: 85%

“…Developing tools to identify patients who will likely not meet the MCID following TJR is important; recommending against surgery for these patients will spare patients the stress of invasive procedures and allow physicians to focus on more effective pain management, as well as lower the economic cost of these surgeries. Previous studies have investigated multiple pre‐operative predictors of surgical outcome, focusing on surgical factors (pre‐operative pain and function score, joint replaced, implant type, anesthesia used, time in surgery, length of hospital stay), demographics (age, sex, body mass index [BMI], ethnicity), anthropological factors (socioeconomic status, marital status, level of education), comorbidities, medical history (radiographic OA grade, mental health, history of joint injury or surgery), and patient expectations . However, the predictive power of these associations varies between studies; while Judge et al reported female sex was a predictor of function non‐response to THR, Weber et al reported male sex was a predictor of pain and function non‐response to both TKR and THR .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Metabolomics Signature for Non‐Responders to Total Joint Replacement Surgery in Primary Osteoarthritis Patients: The Newfoundland Osteoarthritis Study

Costello

Liu

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

Although total joint replacement (TJR) surgery is considered as the most effective treatment for advanced osteoarthritis (OA) patients, up to one‐third of patients reported unfavorable long‐term post‐operative pain outcomes. We aimed to identify metabolic biomarkers to predict non‐responders to TJR using a metabolomics approach. TJR patients were recruited and followed‐up at least 1‐year post‐surgery; TJR outcomes were assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function subscales. Targeted metabolomic profiling was performed on plasma samples collected pre‐surgery and pairwise metabolite ratios, as proxies for enzymatic reactions, were calculated. Association tests were performed between each metabolite ratio and non‐responders. The metabolome‐wide significance was defined as p < 2 × 10−5. A total of 461 TJR patients due to primary OA were included in the analysis. Fifteen percent of patients were classified as pain non‐responders; 16% were classified as function non‐responders. Lower baseline WOMAC pain and function scores were significantly associated with pain and function non‐responders, respectively (both p < 0.03). Two metabolite ratios were significantly associated with pain non‐responders; acetylcarnitine (C2) to phosphatidylcholine acyl‐alkyl C40:1 (PC ae C40:1) was five times higher in pain non‐responders whereas phosphatidylcholine diacyl C36:4 (PC aa C36:4) to isoleucine was twenty one times lower in pain non‐responders than responders (all p ≤ 1.93 × 10−5). One metabolite ratio, glutamine to isoleucine, was significantly lower in function non‐responders than responders (eight times lower; p = 1.08 × 10−5). Three metabolite ratios (C2 to PC ae C40:1, PC aa C36:4, and glutamine to isoleucine) related to inflammation and muscle breakdown could be considered as novel plasma markers for predicting non‐responders to TJR and warrant further investigation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:793‐802, 2020

show abstract

Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 85%

mentioning

confidence: 99%

See 1 more Smart Citation

Metabolomics Signature for Non‐Responders to Total Joint Replacement Surgery in Primary Osteoarthritis Patients: The Newfoundland Osteoarthritis Study

Costello

Liu

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…Although worse pre‐operative pain and patient‐reported function and quality of life have been associated with lower post‐operative absolute scores, it should be noted that often the improvement (difference between post‐operative and pre‐operative scores) is greater in patients with lower pre‐operative scores . This makes intuitive sense but may be due to ceiling effects in some scores used, whereby patients with less severe pre‐operative symptoms have less room to improve.…”

Section: Patient Characteristics Influencing Decision Makingmentioning

confidence: 99%

Selecting and optimising patients for total knee arthroplasty

Adie

Harris

Chuan

et al. 2019

Medical Journal of Australia

View full text Add to dashboard Cite

Summary The minimum requirements for total knee arthroplasty (TKA) are significant, prolonged symptoms with supporting clinical and radiological signs. Despite interest in screening tools, there is limited evidence for a specific symptom threshold that justifies surgery. Non‐operative treatments including medications, exercise and weight loss are unlikely to reverse radiographic changes, but they may improve symptoms and delay the need for surgery. Many patient factors such as mental health and obesity affect both the level of symptomatic improvement after surgery and risks of surgery, but none have been identified as contraindications for the procedure as significant health gains can still be achieved. Although age and sex are associated with patient‐reported outcomes and risk of revision, these factors cannot be used to restrict access to TKA, and age cut‐offs are not recommended. Evidence regarding pre‐operative optimisation of patients to improve post‐operative TKA outcomes is limited by the few interventional trials available, particularly in the areas of patient expectation, diabetes, obesity and vascular disease. There is good evidence from randomised controlled trials that pre‐operative rehabilitation primarily focusing on exercises for the joint or limb has minimal effect on post‐operative TKA outcomes, and there is some evidence from randomised controlled trials that an intensive smoking cessation program before surgery may improve post‐operative outcomes. Detailed international guidelines exist on the optimisation of the cardiorespiratory status of surgical patients, and these should be followed for TKA surgery.

show abstract

“…Age is another factor that is actively related to the period after surgery, 28 being an important predictor of functional outcome. 30 In the study, patients older than 70 years presented a relative frequency of 45.45% in the intervention group and 43.47% in the control group.…”

Section: Eficácia Do Tratamento Adjuvante Da Dor Pós-artroplastia Totmentioning

confidence: 76%

Effectiveness of lidocaine patches for pain treatment after total knee arthroplasty

Sadigursky¹,

Oliveira²,

Macedo³

et al. 2017

Medical Express

View full text Add to dashboard Cite

BACKGROUND:Effective analgesic therapy in the postoperative period of total knee arthroplasty is essential for good surgical outcomes. The current trend is to use multimodal treatment, in which the use of patches with lidocaine as adjuvant therapy has an increasingly relevant role. OBJECTIVE: To investigate the potential benefits of lidocaine patch association with the basic analgesia regimen for pain relief during the postoperative period of total knee arthroplasty. METHOD: A retrospective cohort study was performed , with a total of 24 patients in each group, who underwent total knee arthroplasty. Pain levels using a visual analogue scale and opioid intake were controlled from the immediate postoperative to the end of a 28-day interval. RESULTS: During the postoperative period, pain was less intense in patients who used lidocaine patches. In these same patients, the doses of opioids needed to control pain were lower in 15 of the 28 days analyzed. The relative frequency of nausea was higher in the group that did not use adjuvant therapy. Patients older than 70 years and females predominated. CONCLUSION: Adjuvant treatment after total knee arthroplasty using lidocaine patches was effective in reducing pain and decreasing the use of opioids in the period analyzed, and represents a good addition to multimodal analgesic therapy.

show abstract

Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty

Abstract: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 85 publications

References 35 publications

Metabolomics Signature for Non‐Responders to Total Joint Replacement Surgery in Primary Osteoarthritis Patients: The Newfoundland Osteoarthritis Study

Metabolomics Signature for Non‐Responders to Total Joint Replacement Surgery in Primary Osteoarthritis Patients: The Newfoundland Osteoarthritis Study

Selecting and optimising patients for total knee arthroplasty

Effectiveness of lidocaine patches for pain treatment after total knee arthroplasty

Contact Info

Product

Resources

About