Variation in age and physical status prior to total knee and hip replacement surgery: A comparison of centers in Australia and Europe

Abstract

Objective. To investigate whether variation exists in the preoperative age, pain, stiffness, and physical function of people undergoing total knee replacement (TKR) and total hip replacement (THR) at several centers in Australia and Europe. Methods. Individual Western Ontario and McMaster Universities Osteoarthritis Index data (range 0 -100, where 0 ‫؍‬ best and 100 ‫؍‬ worst) collected within 6 weeks prior to primary TKR and THR were extracted from 16 centers (n ‫؍‬ 2,835) according to specified eligibility criteria. Analysis of covariance was used to evaluate differences in pain, stiffness, and physical function between centers, with adjustment for age and sex.

The association between radiographic severity and pre-operative function in patients undergoing primary knee replacement for osteoarthritis

“…The sourcing of patients from a single centre was a potential source of selection bias. While our patient demographic is similar to that of other arthroplasty centres with respect to age [17,51] and obesity rates [52,53], the percentage of women who underwent knee replacement was marginally higher than that of other centres [17,51]. We recognise the limitations of using the International Knee Society Score (IKS) in terms of potential observer bias associated with a scoring system that is partly completed by the health care provider [54].…”

Patient decision aids in knee replacement surgery

“…A recent Swedish study using a standardised indication criteria assessment tool for patients selected for primary hip or knee replacement surgery found significant variations between hospitals [28]. Patient factors such as age, obesity and co-morbidities have been shown to affect the surgeon's threshold to proceed to joint replacement [27,29].…”

Long-Term Pain and Functional Disability After Total Knee Arthroplasty With and Without Single-Injection or Continuous Sciatic Nerve Block in Addition to Continuous Femoral Nerve Block

“…25 Furthermore, joint replacements in patients with severe preoperative pain and poor physical function are associated with worse postoperative outcomes. 26 Thus, pain treatment for TKA should be focused on reducing existing preoperative chronic pain and may be initiated before TKA. Therefore, we analyzed post hoc the category of patients with moderate to poor preoperative functioning (WOMAC e36.7).…”