Predictors of Outcome After Primary Total Joint Replacement

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

“…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 .…”

“…A significant difference was seen in baseline pain and function WOMAC scores, which were lower in non‐responders. This is consistent with previous reports . However, previous studies have also found higher baseline PROM scores to be associated with non‐responders; again, this can likely be attributed to differences in PROMs used, populations studied, and MCID definitions.…”

“…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 .…”

“…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 . Similar inconsistencies are seen with other commonly reported variables including age, BMI, comorbidities, pre‐operative pain scores, and pre‐operative function scores .…”

“…[7][8][9][10][11] 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, 8 Weber et al reported male sex was a predictor of pain and function non-response to both TKR and THR. 9 Similar inconsistencies are seen with other commonly reported variables including age, BMI, comorbidities, pre-operative pain scores, and preoperative function scores. [7][8][9][10] 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.…”