Quality-Adjusted Life Years After Hip and Knee Arthroplasty

Konopka, Joseph F.; Lee, Yuo-yu; Su, Edwin P.; McLawhorn, Alexander S.

doi:10.2106/jbjs.oa.18.00007

Cited by 104 publications

(81 citation statements)

References 23 publications

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“…The increasing prevalence of OA during the last decades emphasizes the importance of more effective preventive and/or therapeutic strategies based on reliable diagnostic and prognostic markers [3]. In late-stage OA, joint replacement is mostly the last effective treatment option to alleviate pain and loss of functionality (including joint stiffness) in order to improve the quality of life [4]. While hip and knee arthroplasty are highly successful and cost-effective in most cases [5], about 10% to 20% of patients do not benefit much from this surgical approach, an aspect which is still insufficiently understood [6,7].…”

Section: Introductionmentioning

confidence: 99%

Serum Cartilage Oligomeric Matrix Protein in Late-Stage Osteoarthritis: Association with Clinical Features, Renal Function, and Cardiovascular Biomarkers

Riegger

Rehm

Büchele

et al. 2020

JCM

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This study aimed to assess associations between serum cartilage oligomeric matrix protein (sCOMP) and phenotypic characteristics in late-stage hip and knee Osteoarthritis (OA) as well as its correlation with further serum markers of possible comorbidities in the Ulm Osteoarthritis Study. Moreover, the prognostic relevance of preoperative sCOMP concentrations for short-term functionality and pain outcomes after hip or knee joint replacement was explored. Preoperative serum samples and detailed information about the health status (i.e., WOMAC scores, Hannover Functionality Status (FFbH)) of 754 OA patients undergoing total joint replacement were included. Spearman rank-correlation coefficients and multiple linear regression models were used to evaluate the relationships between sCOMP, other serum markers, and health outcomes. There was a significant positive association between sCOMP and markers of renal (cystatin C, creatinine, and eGFR) and cardiac (e.g., NT-proBNP) impairment. Since renal failure might cause accumulation of sCOMP, additional adjustment with eGFR was performed. Preoperative sCOMP levels in knee OA but not hip OA patients were positively associated with FFbH, WOMAC function sub-scale and total WOMAC scale as well as the post-operative WOMAC stiffness sub-scale six months after surgery. Our data clearly demonstrate an association between sCOMP and renal function as well as other confounding factors, which should be considered in future biomarker studies.

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Section: Introductionmentioning

confidence: 99%

Serum Cartilage Oligomeric Matrix Protein in Late-Stage Osteoarthritis: Association with Clinical Features, Renal Function, and Cardiovascular Biomarkers

Riegger

Rehm

Büchele

et al. 2020

JCM

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“…Pain and loss of function are the predominant symptoms that lead to treatment, including non-pharmacological, pharmacological, and surgical approaches [4]. The eventual treatment for end-stage hip osteoarthritis is joint replacement surgery, which is a very successful operation in terms of clinical outcomes [5][6][7] and cost-effectiveness [8,9]. However, surgery still presents major risks and complications such as dislocation, blood clots and infection [10].…”

Section: Introductionmentioning

confidence: 99%

Self-Management of Hip Osteoarthritis Five Years After a Cycling and Education Treatment Pathway

et al. 2020

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The Cycling against Hip Pain (CHAIN) programme is a six-week cycling and education treatment pathway for people with hip osteoarthritis. Preliminary results demonstrated significant improvements in clinical and patient-reported outcome measures following the course. Whilst the benefits of exercise for osteoarthritis are often reported in the short term, less is known about the long-term effects for this patient group. This study explores whether participants continued to self-manage their hip osteoarthritis five years after completing the course. A cross-sectional survey was conducted to collect data from participants who completed the CHAIN programme between October 2013 and February 2015 (n = 96). Questionnaires were sent by post in April 2019, and then non-responders were followed up again four weeks later. Eighty-three (87%) participants responded to the survey. Five years (range 4–6) after completion of a six-week cycling and education programme, 37 (45%) participants had not returned to their general practitioner for further treatment of their hip pain, and 47 (57%) had not pursued surgical intervention. All participants were still engaged in at least one physical activity per week and many reported that they had purchased a bike (29%), joined a gym (30%) or cycled regularly (indoor cycling 25%, outdoor cycling 24%). Eighty (96%) participants reported an increase in knowledge of self-managing their symptoms. The findings from this study suggest that many patients are motivated to self-manage their hip osteoarthritis, five years following a six-week cycling and education treatment pathway that encourages lifestyle change.

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“…Primary hip and knee arthroplasties are increasingly common orthopaedic surgical interventions that improve patients’ quality of life. 1 The UK National Joint Registry (NJR) reported over 200,000 primary hip and knee arthroplasties carried out in England, Wales, Northern Ireland and Isle of Man in 2018, with further increases predicted with time. 2 In the USA, a similar trend is observed with a projected increase of 145% and 147% for total hip arthroplasties (THAs) and total knee arthroplasties (TKAs) respectively by the year 2030.…”

Section: Introductionmentioning

confidence: 99%

Prolonged length of stay (PLOS) in a high-volume arthroplasty unit

et al. 2020

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Introduction The enhanced recovery after surgery (ERAS) concept in arthroplasty surgery has led to a reduction in postoperative length of stay in recent years. Patients with prolonged length of stay (PLOS) add to the burden of a strained NHS. Our aim was to identify the main reasons. Methods A PLOS was arbitrarily defined as an inpatient hospital stay of four days or longer from admission date. A total of 2,000 consecutive arthroplasty patients between September 2017 and July 2018 were reviewed. Of these, 1,878 patients were included after exclusion criteria were applied. Notes for 524 PLOS patients were audited to determine predominant reasons for PLOS. Results The mean total length of stay was 4 days (1 to 42). The top three reasons for PLOS were social services, day-before-surgery admission, and slow to mobilize. Social services accounted for 1,224 excess bed days, almost half (49.2%, 1,224/2,489) of the sum of excess bed days. Conclusion A preadmission discharge plan, plus day of surgery admission and mobilization on the day of surgery, would have the potential to significantly reduce length of stay without compromising patient care. Cite this article: Bone Joint Open 2020;1-8:488–493.

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Quality-Adjusted Life Years After Hip and Knee Arthroplasty

Cited by 104 publications

References 23 publications

Serum Cartilage Oligomeric Matrix Protein in Late-Stage Osteoarthritis: Association with Clinical Features, Renal Function, and Cardiovascular Biomarkers

Serum Cartilage Oligomeric Matrix Protein in Late-Stage Osteoarthritis: Association with Clinical Features, Renal Function, and Cardiovascular Biomarkers

Self-Management of Hip Osteoarthritis Five Years After a Cycling and Education Treatment Pathway

Prolonged length of stay (PLOS) in a high-volume arthroplasty unit

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