All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study

Nüesch, Eveline; Dieppe, Paul; Reichenbach, Stephan; Williams, Susan; Iff, Samuel; Jüni, Peter

doi:10.1136/bmj.d1165

Cited by 613 publications

(572 citation statements)

References 41 publications

Supporting

Mentioning

511

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have demonstrated an increased risk of deep vein thrombosis and pulmonary embolism in patients with RA relative to the age and sex-matched general population without RA, likely due to the effects of systemic inflammation and endothelial dysfunction (50,51). Our findings may be the result of selection bias; it may be that healthier patients with RA are selected for THA and/or there may be an overall higher risk of venous thromboembolism among patients with advanced OA relative to the age and sex-matched general population without OA (52).…”

Section: Discussionmentioning

confidence: 69%

Increased Risk of Complications Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Ravi

Croxford

Hollands

et al. 2014

Arthritis & Rheumatology

163

View full text Add to dashboard Cite

Objective. Most of the evidence regarding complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are based on patients with osteoarthritis (OA); less is known about outcomes in rheumatoid arthritis (RA). Using a validated algorithm for identifying patients with RA, we undertook this study to compare the rates of complications among THA and TKA recipients between those with RA and those without RA.Methods. In patients who underwent a first primary elective THA or TKA between 2002 and 2009, those with RA were identified using a validated algorithm: a hospitalization with a diagnosis code for RA or 3 physician billing claims with a diagnosis code for RA, with at least 1 claim by a specialist (rheumatologist, orthopedic surgeon, or internist) in a 2-year period. Recipients with diagnostic codes suggesting an inflammatory arthritis, but not meeting RA criteria, were classified as having inflammatory arthritis. All remaining patients were deemed to have OA. Cox proportional hazards models, censored on death, were used to determine the relationship between the type of arthritis and the occurrence of specific complications, adjusting for potential confounders (age, sex, comorbidity, and provider volume).Results. We identified 43,997 eligible THA recipients (3% with RA) and 71,793 eligible TKA recipients (4% with RA). Total joint arthroplasty recipients with RA had higher age and sex-standardized rates of dislocation following THA (2.45%, compared with 1.21% for recipients with OA) and higher age and sex-standardized rates of infection following TKA (1.26%, compared with 0.84% for recipients with OA). Controlling for potential confounders, recipients with RA remained at increased risk of dislocation within 2 years of THA (adjusted hazard ratio [HR] 1.91, P ‫؍‬ 0.001) and remained at increased risk of infection within 2 years of TKA (adjusted HR 1.47, P ‫؍‬ 0.03) relative to recipients with OA.Conclusion. Patients with RA are at higher risk of dislocation following THA and are at higher risk of infection following TKA relative to those with OA. Further research is warranted to elucidate explanations for these findings, including the roles of medication profile, implant choice, postoperative antibiotic protocol, and method of rehabilitation following joint replacement.

show abstract

Section: Discussionmentioning

confidence: 69%

Increased Risk of Complications Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Ravi

Croxford

Hollands

et al. 2014

Arthritis & Rheumatology

163

View full text Add to dashboard Cite

show abstract

“…Quality-of-life studies suggest the impact of OA to be comparable to that of cardiac, neurological, and pulmonary diseases. [5][6][7] OA is also the leading cause of absence from work, costing the UK economy upwards of £18 billion annually and together with other musculoskeletal diseases accounts for almost one-tenth of the total annual NHS budget (£10 billion annually) and 12% of primary-care consultations [4,8]. Improving health-related quality-of-life for people with longterm conditions such as OA is a current NHS priority [9].…”

Section: Introductionmentioning

confidence: 99%

Impact and therapy of osteoarthritis: the Arthritis Care OA Nation 2012 survey

et al. 2014

View full text Add to dashboard Cite

Osteoarthritis (OA) is the fastest growing cause of disability worldwide. The aim of this study was to understand the impact of OA on individuals and to explore current treatment strategies. An online UK-wide survey of people with self-reported OA was conducted composed of 52 questions exploring the impact of OA, diagnosis and treatment, the role of health professionals and self-management. 4,043 people were invited with 2,001 respondents (49% response, 56% women, mean age 65 years). 52% reported that OA had a large impact on their lives. 15% of respondents had taken early retirement, on average 7.8 years earlier than planned. In consultations with general practitioners, only half reported a discussion on pain; fewer reported discussing their fears (21%) or management goals (15%).Nearly half (48%) reported not seeking medical help until pain was frequently unbearable.Oral analgesics (62%), topical therapies (47%), physiotherapy (38%) and steroid injections (28%) were commonly used. The majority (71%) reported varying degrees of persistent pain despite taking all prescribed medication. Although 64% knew that increasing exercise was important, only 36% acted on this knowledge; 87% who increased exercise found it beneficial. Over half had future concerns related to mobility (60%), maintaining independence (52%) and coping with everyday activities (51%). OA had significant individual economic impact especially on employment. Current treatment strategies still leave most people in pain with significant fears for the future. There is considerable opportunity to improve the holistic nature of OA consultations especially in provision of information and promotion of self-management strategies.

show abstract

“…Limitations in physical function are associated with participation restrictions in people with knee osteoarthritis (OA) (1), and they predicted mortality independent of traditional risk factors (2). Compared with people without knee OA, those with knee OA have lower knee extensor strength (force-generating capacity) (3)(4)(5)(6) and impaired standing balance (5)(6)(7)(8), commonly defined as greater postural body sway or center of pressure (COP) displacement, suggesting that both reduced knee extensor strength and standing balance are potential impairments to be evaluated in the research and clinical settings as they may influence functional limitations in knee OA.…”

Section: Introductionmentioning

confidence: 99%

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis

Pua

Liang

Ong

et al. 2011

Arthritis Care & Research

View full text Add to dashboard Cite

Objective. Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. Methods. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ؎ SD age 67 ؎ 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. Results. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balancephysical function associations were, or tended to be, negative. Conclusion. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study.

show abstract

All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study

Cited by 613 publications

References 41 publications

Increased Risk of Complications Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Increased Risk of Complications Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Impact and therapy of osteoarthritis: the Arthritis Care OA Nation 2012 survey

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis

Contact Info

Product

Resources

About