The University of Southampton
University of Southampton Institutional Repository

Predictors of outcomes of total knee replacement surgery

Predictors of outcomes of total knee replacement surgery
Predictors of outcomes of total knee replacement surgery
Objective: to identify pre-operative predictors of patient-reported outcomes of primary total knee replacement (TKR) surgery.

Methods: the Elective Orthopaedic Centre database is a large prospective cohort of 1991 patients receiving primary TKR in south-west London from 2005 to 2008. The primary outcome is the 6-month post-operative Oxford Knee Score (OKS). To classify whether patients had a clinically important outcome, we calculated a patient acceptable symptom state (PASS) for the 6-month OKS related to satisfaction with surgery. Potential predictor variables were pre-operative OKS, age, sex, BMI, deprivation, surgical side, diagnosis, operation type, American Society of Anesthesiologists grade and EQ5D anxiety/depression. Regression modelling was used to identify predictors of outcome.

Results: the strongest determinants of outcome include pre-operative pain/function—those with less severe pre-operative disease obtain the best outcomes; diagnosis in relation to pain outcome—patients with RA did better than those with OA; deprivation—those living in poorer areas had worse outcomes; and anxiety/depression—worse pre-operative anxiety/depression led to worse pain. Differences were observed between predictors of pain and functional outcomes. Diagnosis of RA and anxiety/depression were associated with pain, whereas age and gender were specifically associated with function. BMI was not a clinically important predictor of outcome.

Conclusion: this study identified clinically important predictors of attained pain/function post-TKR. Predictors of pain were not necessarily the same as functional outcomes, which may be important in the context of a patient’s expectations of surgery. Other predictive factors need to be identified to improve our ability to recognize patients at risk of poor TKR outcomes
1462-0324
1804-1813
Judge, Andy
a7b98e8c-fd10-42be-a35a-ca6359038f95
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Javaid, M. Kassim
64155236-2ef0-4065-b684-cf723a888117
Carr, Andrew J.
f37df723-ef0e-4c91-92f2-733145030178
Field, Richard E.
6410e9d7-5cab-468b-842a-53941b866e4a
Dieppe, Paul A.
ba96f564-f9b8-4012-a124-ea57f038b92d
Judge, Andy
a7b98e8c-fd10-42be-a35a-ca6359038f95
Arden, Nigel K.
23af958d-835c-4d79-be54-4bbe4c68077f
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Javaid, M. Kassim
64155236-2ef0-4065-b684-cf723a888117
Carr, Andrew J.
f37df723-ef0e-4c91-92f2-733145030178
Field, Richard E.
6410e9d7-5cab-468b-842a-53941b866e4a
Dieppe, Paul A.
ba96f564-f9b8-4012-a124-ea57f038b92d

Judge, Andy, Arden, Nigel K., Cooper, Cyrus, Javaid, M. Kassim, Carr, Andrew J., Field, Richard E. and Dieppe, Paul A. (2012) Predictors of outcomes of total knee replacement surgery. Rheumatology, 51 (10), 1804-1813. (doi:10.1093/rheumatology/kes075). (PMID:22532699)

Record type: Article

Abstract

Objective: to identify pre-operative predictors of patient-reported outcomes of primary total knee replacement (TKR) surgery.

Methods: the Elective Orthopaedic Centre database is a large prospective cohort of 1991 patients receiving primary TKR in south-west London from 2005 to 2008. The primary outcome is the 6-month post-operative Oxford Knee Score (OKS). To classify whether patients had a clinically important outcome, we calculated a patient acceptable symptom state (PASS) for the 6-month OKS related to satisfaction with surgery. Potential predictor variables were pre-operative OKS, age, sex, BMI, deprivation, surgical side, diagnosis, operation type, American Society of Anesthesiologists grade and EQ5D anxiety/depression. Regression modelling was used to identify predictors of outcome.

Results: the strongest determinants of outcome include pre-operative pain/function—those with less severe pre-operative disease obtain the best outcomes; diagnosis in relation to pain outcome—patients with RA did better than those with OA; deprivation—those living in poorer areas had worse outcomes; and anxiety/depression—worse pre-operative anxiety/depression led to worse pain. Differences were observed between predictors of pain and functional outcomes. Diagnosis of RA and anxiety/depression were associated with pain, whereas age and gender were specifically associated with function. BMI was not a clinically important predictor of outcome.

Conclusion: this study identified clinically important predictors of attained pain/function post-TKR. Predictors of pain were not necessarily the same as functional outcomes, which may be important in the context of a patient’s expectations of surgery. Other predictive factors need to be identified to improve our ability to recognize patients at risk of poor TKR outcomes

Full text not available from this repository.

More information

e-pub ahead of print date: 24 April 2012
Published date: October 2012
Organisations: Faculty of Medicine, Faculty of Health Sciences

Identifiers

Local EPrints ID: 346802
URI: http://eprints.soton.ac.uk/id/eprint/346802
ISSN: 1462-0324
PURE UUID: c87ee52e-974a-4992-8e96-14b33d75a13a
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 10 Jan 2013 12:24
Last modified: 17 Dec 2019 01:56

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×