The effect of multimorbidity on changes in health-related quality of life following hip and knee arthroplasty

Zhang, L.; Lix, Lisa M.; Ayilara, Olawale; Sawatzky, Richard; Bohm, Éric

doi:10.1302/0301-620x.100b9.bjj-2017-1372.r1

Cited by 27 publications

(29 citation statements)

References 186 publications

(384 reference statements)

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“…The SF‐12 has also been shown to be able to discriminate between patients with rheumatoid arthritis of the hands/wrists who have high pain and those with low pain (PCS ES = 0.81 and MCS ES = 0.33) . In addition, the responsiveness of the SF‐12 to a wide range of treatments and programs for musculoskeletal conditions has been reported .…”

Section: Medical Outcomes Study 12‐item Short Form Health Surveymentioning

confidence: 96%

Adult Measures of General Health and Health‐Related Quality of Life

Busija

Ackerman

Haas

et al. 2020

Arthritis Care & Research

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Section: Medical Outcomes Study 12‐item Short Form Health Surveymentioning

confidence: 96%

Adult Measures of General Health and Health‐Related Quality of Life

Busija

Ackerman

Haas

et al. 2020

Arthritis Care & Research

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“…These differences have the potential to help illustrate how variations in patient selection (preoperative disease severity, age, sex, comorbidities) and processes of care delivery (for example public versus private funding) can affect rates of surgery and surgical outcomes. However, these comparisons need to be done thoughtfully, as confounding factors such as age, sex, body mass index, comorbidities 54 and socioeconomic status 55 among others may make comparisons difficult. 9 The use of different PROMs tools across registries also presents unique challenges, since robust ‘cross walk’ algorithms will need to be developed to allow for valid comparisons.…”

Section: Comparisons Of Proms Data Across Registriesmentioning

confidence: 99%

“…While PROMs cannot yet be used at the individual patient level to determine a cut point or appropriateness for surgery, 63 their collection in registries does allow for a better understanding of how other related factors such as age, sex, preoperative disease severity, generic QoL and comorbidities broadly affect the outcome of surgery at the population level. 54,64 This can help inform the individual decision-making process as the information can be incorporated into the clinical setting and, when counselling potential arthroplasty patients regarding surgery, reasonable expectations can be discussed based on fact rather than conjecture. 50 The inability to precisely predict appropriateness at the individual patient level using PROMs is related to poor questionnaire reliability at the individual level, the impact that patient demographics, diagnosis, expectations and comorbidities have on outcome and the lack of validation of PROMs for this purpose.…”

Section: Comparisons Of Proms Data Across Registriesmentioning

confidence: 99%

Orthopaedic registries with patient-reported outcome measures

et al. 2019

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Total joint arthroplasty is performed to decreased pain, restore function and productivity and improve quality of life. One-year implant survivorship following surgery is nearly 100%; however, self-reported satisfaction is 80% after total knee arthroplasty and 90% after total hip arthroplasty. Patient-reported outcomes (PROs) are produced by patients reporting on their own health status directly without interpretation from a surgeon or other medical professional; a PRO measure (PROM) is a tool, often a questionnaire, that measures different aspects of patient-related outcomes. Generic PROs are related to a patient’s general health and quality of life, whereas a specific PRO is focused on a particular disease, symptom or anatomical region. While revision surgery is the traditional endpoint of registries, it is blunt and likely insufficient as a measure of success; PROMs address this shortcoming by expanding beyond survival and measuring outcomes that are relevant to patients – relief of pain, restoration of function and improvement in quality of life. PROMs are increasing in use in many national and regional orthopaedic arthroplasty registries. PROMs data can provide important information on value-based care, support quality assurance and improvement initiatives, help refine surgical indications and may improve shared decision-making and surgical timing. There are several practical considerations that need to be considered when implementing PROMs collection, as the undertaking itself may be expensive, a burden to the patient, as well as being time and labour intensive. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180080

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“…TKA and THA are common considerations for effective procedures for patients with advanced osteoarthritis [7,10]. Although using comorbidities to predict clinical outcomes has increased substantially in the past 20 years for patients undergoing TKA and THA [2,6,11,12], their relationship to the risk of revision is unclear. Moreover, most joint arthroplasty patients have a high prevalence of comorbidities, which can affect surgical outcomes, and previous studies have identified risk factors associated with lower implant survival [13].…”

Section: Introductionmentioning

confidence: 99%

Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty

Torre

Smith

Dregan

et al. 2020

BMC Musculoskelet Disord

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Background: The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA. Methods: Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. As main explanatory factors, comorbidity burden was assessed by the Elixhauser index, categorized, and specific comorbidities from the index were taken into account. Descriptive analyses for comorbidity burden and specific conditions were done. Additionally, incidence at 1 and 5 years' follow-up was calculated, and adjusted Competing Risks models were fitted. Results: A higher incidence of revision was observed when the number of comorbidities was high, both at 1 and 5 years for THA, but only at 1 year for TKA. Of the specific conditions, only obesity was related to the incidence of revision at 1 year in both joints, and at 5 years in TKA. The risk of revision was related to deficiency anemia and liver diseases in TKA, while in THA, it was related to peripheral vascular disorders, metastatic cancer and psychoses. Conclusions: Different conditions, depending on the joint, might be related to higher revision rates. This information could be relevant for clinical decision-making, patient-specific information and improving the results of both TKA and THA.

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The effect of multimorbidity on changes in health-related quality of life following hip and knee arthroplasty

Cited by 27 publications

References 186 publications

Adult Measures of General Health and Health‐Related Quality of Life

Adult Measures of General Health and Health‐Related Quality of Life

Orthopaedic registries with patient-reported outcome measures

Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty

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