Predicting quality-of-life outcomes following total joint arthroplasty

McGuigan, Francis X.; Hozack, William J.; Moriarty, Lisa; K, Eng; Rothman, Richard H.

doi:10.1016/s0883-5403(05)80069-5

Cited by 120 publications

(83 citation statements)

References 18 publications

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“…In the first global model, when combining the significant predictors of each category of variables (adjusted R 2 66%), the largest contribution to the predicted variance was made by the preoperative 6-minute distance (56.6%), followed by knee flexion (4.7%), and then knee pain (4.2%). This result is not surprising since the baseline measure of the dependent variable is usually a strong predictor in regression analyses (6,19,20,22). Although, these proportions of explained variance could be considered optimistic because the development of the model capitalize on chance (138), we demonstrated through internal validation that this model was not overly optimistic.…”

Section: Discussionmentioning

confidence: 74%

“…The best predictive model combines variables from 2 of the 3 categories studied and can predict a moderate to good proportion of the variance (66%) of the early locomotor ability after TKA (Interpretation guide for the value of R 2 proposed by McGuigan et al [20]: 0.01-0.25 ϭ no relationship; 0.26 -0.50 ϭ fair relationship; 0.51-0.75 ϭ moderate/good rela- The measures from the Capability category were found to be the most powerful predictors. On the other hand, complex laboratory measures (such as power peak) were found not to be essential.…”

Section: Discussionmentioning

confidence: 99%

“…Males with few comorbidities and low body mass indices were among participants who had a better locomotor ability 2 months after TKA. Altogether, these variables are considered to have only a "fair" predictive value (20) demonstrating that they need to be combined to organic system and capability variables to increase the precision of the prediction.…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge, it is the first time that a longitudinal association between a quantitative measure of locomotor ability and these personal characteristics is observed in persons with TKA. This may be explained by the fact that these personal characteristics are associated with other potential predictors such as locomotor measures (Table 4), strength (17,147), and pain (20,26). Thus, when these latter predictors are retained in the regression analyses, personal predictors do not have an independent contribution to the prediction.…”

Section: Discussionmentioning

confidence: 99%

“…Instead, previous studies have predicted self-reported functional ability after TKA and total hip arthroplasty using questionnaires (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Among these studies, only 4 used a questionnaire that evaluates specifically the physical function of the lower limbs (15,19,20,27). In other studies, the variables predicted were not directly related to functional ability (e.g., length of stay, discharge destination, occurrence of complications, or surgical failure) (18,29 -36) or long-term postoperative outcomes were predicted using postoperative variables measured earlier in the recovery period (37)(38)(39).…”

Section: Introductionmentioning

confidence: 99%

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Preoperative predictors of locomotor ability two months after total knee arthroplasty for severe osteoarthritis

Parent

Moffet

2003

Arthritis & Rheumatism

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Objective. To identify preoperative predictors of locomotor ability 2 months after total knee arthroplasty (TKA). Methods. Sixty-five participants scheduled for a first TKA were recruited. The dependent variable was the distance covered during the 6-minute gait test 2 months after TKA. The independent variables, measured before surgery, were grouped into 3 categories: 1) personal; 2) organic system, and 3) capability variables. Multiple regression analyses were conducted to determine the best predictors of the dependent variable. Modified cross-validation of the model combining predictors from the three categories was obtained with 10 random samples derived from the original cohort by resampling with replacement. Results. Predictors were identified in the 3 categories: 1) gender, number of comorbidities, body mass index, 2) knee pain, flexion and strength, lower limb mechanical power, and 3) preoperative 6-minute gait distance. When these variables were modeled together only the preoperative 6-minute gait distance and knee pain and flexion remained significant (adjusted R 2 ‫؍‬ 0.66). Conclusion. Using variables easily measured before surgery, it is possible to predict with good accuracy locomotor ability 2 months after TKA.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Preoperative predictors of locomotor ability two months after total knee arthroplasty for severe osteoarthritis

Parent

Moffet

2003

Arthritis & Rheumatism

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Outcomes of total hip and knee replacement: Preoperative functional status predicts outcomes at six months after surgery

Fortin

Clarke

Joseph

et al. 1999

Arthritis & Rheumatism

657

362

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Objective. To determine whether patients with knee or hip osteoarthritis (OA) who have worse physical function preoperatively achieve a postoperative status that is similar to that of patients with better preoperative function.Methods. This study surveyed an observational cohort of 379 consecutive patients with definite OA who were without other inflammatory joint diseases and were undergoing either total hip or knee replacement in a US (Boston) and a Canadian (Montreal) referral center. Questionnaires on health status (the Short Form 36 and Western Ontario and McMaster Universities Osteoarthritis Index) were administered preoperatively and at 3 and 6 months postoperatively. Physical function and pain due to OA were deemed the most significant outcomes to study.Results. Two hundred twenty-two patients returned their questionnaires. Patients in the 2 centers were comparable in age, sex, time to surgery, and proportion of hip/knee surgery. The Boston group had more education, lower comorbidity, and more cemented knee prostheses. Patients undergoing hip or knee replacement in Montreal had lower preoperative physical function and more pain than their Boston counterparts. In patients with lower preoperative physical function, function and pain were not improved postoperatively to the level achieved by those with higher preoperative function. This was most striking in patients undergoing total knee replacement.Conclusion. Surgery performed later in the natural history of functional decline due to OA of the knee, and possibly of the hip, results in worse postoperative functional status.

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Importance of self-rated health and mental well-being in predicting health outcomes following total joint replacement surgery for osteoarthritis

Perruccio¹,

Davis²,

Hogg‐Johnson³

et al. 2011

Arthritis Care Res

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Objective. The determinants of outcomes and the scope of outcomes examined in total joint replacement (TJR) typically have been limited to aspects of physical health. We investigated mental well-being, physical and social health, and self-rated health (SRH) as predictors of future health status within a cohort undergoing a TJR for hip or knee osteoarthritis. We also investigated the interrelationships among these health dimensions as they relate to SRH. Methods. Participants (n ‫؍‬ 215 hip, n ‫؍‬ 234 knee) completed measures presurgery and 3 and 6 months postsurgery, including pain, physical function, fatigue, anxiety, depression, social participation limitations, passive/active recreation, community mobility, and SRH. Structural equation modeling was used to investigate the interrelationship between 3 latent health dimensions (physical, mental, social) and the predictive significance of SRH for future health status. Results. The mean age was 63.5 years (range 31-88 years) and 60% were women. Prior dimension status strongly predicted future status. Adjusted for prior dimension scores, comorbidity, and sociodemographic characteristics, SRH predicted future scores for all 3 health dimensions. Worse prior SRH predicted less improvement at all time points. The effects of physical and social health on SRH were fully mediated through mental well-being. Only mental well-being significantly predicted SRH, within and across time. Conclusion. Mental well-being is critical for understanding the relationship between physical health and SRH. In addition, SRH significantly predicts TJR outcomes, above and beyond prior physical health. The exclusive focus on any one health dimension may lead to missed opportunities for predicting and improving outcomes following surgery, and likely improving overall health generally.

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Predicting quality-of-life outcomes following total joint arthroplasty

Cited by 120 publications

References 18 publications

Preoperative predictors of locomotor ability two months after total knee arthroplasty for severe osteoarthritis

Preoperative predictors of locomotor ability two months after total knee arthroplasty for severe osteoarthritis

Outcomes of total hip and knee replacement: Preoperative functional status predicts outcomes at six months after surgery

Importance of self-rated health and mental well-being in predicting health outcomes following total joint replacement surgery for osteoarthritis

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