Early Clinically Relevant Improvement in Quality of Life and Clinical Outcomes 1 Year Postsurgery in Patients with Knee and Hip Joint Arthroplasties

Abstract

Objective To measure and identify the determinants of the outcomes after hip/knee arthroplasty (HA/KA) in patients with osteoarthritis during the first postsurgical year. Design In this prospective observational study, we evaluated the preoperative and postoperative (3, 6, and 12 months) outcomes of 626 patients who underwent HA (346 with median age 65 years, 59% female) or KA (280 with median age 66.5 years, 54% female) between 2008 and 2013. Generic and specific tools were used to measure health-related quality of life (HRQoL) and utility. Good outcome was defined as an improvement in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) greater than or equal to the minimal important difference (MID). Regressions were performed to evaluate the relationship between preoperative and postoperative measures and evolution of WOMAC/good outcome. Results We observed an almost systematic improvement of all parameters for up to 12 months, but especially at the 3-month follow-up. The low number of comorbidities and the absence of postoperative complications were the common determinants of improvement of WOMAC total score after 12 months. Other parameters (background of the joint, preoperative function and length of hospital stay in KA group; place of discharge in HA group) affected the evolution of WOMAC scores. 87.09% of HA and 73.06% of KA patients experienced a good outcome. A small number of comorbidities, a worse preoperative function, a shortened hospital stay (KA only), and an absence of early postoperative complications (HA only) significantly predicted a good outcome. Conclusions Intermediate HRQoL following HA or KA improved quickly from preoperative levels for all instruments. More than 70% of patients achieved a good outcome defined as improved pain, stiffness and disability and the predictors are slightly close.

Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years

“…Therefore, it is important to carefully evaluate the patient's benefits of these surgical interventions. In a previous study, we demonstrated fast (from 3 months), substantial, and shortterm benefits of HA and KA on parameters reflecting quality of life and health utility [10]. We have continued a 5-year follow-up of this large number of OA patients, from both genders, who underwent joint replacement of the knee or hip.…”

“…Then, we performed secondary analyses seeking associations between these factors and good outcome using binary logistic backward regression modeling. Finally, as previously performed, we explored the profile of patients with long-term complications using the same statistical strategy [10]. The odds ratios (ORs) associated with each of the identified predictors were determined using logit regression.…”

“…They were divided in 2 groups (according to surgical site) and were monitored over time from the day before surgery to 5 years after surgery. The full details of the methodology for recruitment and follow-up were previously described [10,11]. During the 5-year follow-up, the evaluation of postoperative outcomes continued through mail on a yearly basis.…”

Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis

“… 16 reported that skeletal muscle mass index is negatively associated with the Kellgren–Lawrence grade (K-L grade) of radiographic KOA. Given that low muscle mass is associated with greater functional impairment 17 and preoperative functional status predicts the functional recovery pattern, 18 , 19 potential sarcopenia in older people with KOA may affect post-surgery outcomes.…”

Complications to 6 months following total hip or knee arthroplasty: observations from an Australian clinical outcomes registry

“…Over 90,000 THA and over 1.1 million TKA procedures were undertaken in 2018 in the UK, whilst in the US, incidence is estimated to grow to 572,000 THA and 3.48 million TKA procedures per annum by 2030 [2]. While these procedures are effective in improving pain and function [3][4][5][6][7], there is a risk of complications. The most common complications requiring readmission for hip arthroplasty are dislocation and infection, whereas infection dominates following knee arthroplasty [8,9].…”