1. The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement
- Author
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Gossec, L., Paternotte, S., Maillefert, J.F., Combescure, C., Conaghan, P.G., Davis, A.M., Gunther, K.P., Hawker, G., Hochberg, M., Katz, J.N., Kloppenburg, M., Lim, K., Lohmander, L.S., Mahomed, N.N., March, L., Pavelka, K., Punzi, L., Roos, E.M., Sanchez-Riera, L., Singh, J.A., Suarez-Almazor, M.E., Dougados, M., OARSI-OMERACT Task Force Total Art, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), APHP, Rheumatology B Department, Service de Rhumatologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Division of Clinical Epidemiology (DCE), Geneva University Hospital (HUG), Section of Musculoskeletal Diseasee, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Division of Health Care and Outcomes Research and Arthritis and Community, Research and Evaluation Unit, Toronto, Department of Orthopaedic Surgery, Université Catholique de Louvain (UCL), Division of Rheumatology, Department of Medicine, Women's College Hospital, University of Toronto, Division of Rheumatology & Clinical Immunology, Department of Orthopedic Surgery, Harvard Medical School [Boston] (HMS), Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands, St Vincent's Hospital & Western Hospital, Melbourne, Department of Orthopaedics, Lund University, Lund, Sweden, Division of Orthopaedic Surgery, University of Toronto, Institute of Bone and Joint Research, The University of Sydney, Institute of Rheumatology, University Prague, Rheumatology Unit, Universita degli Studi di Padova, Institute of Sports and Clinical Biomechanics, University of Southern Denmark (SDU), Birmingham VA Medical Center, University of Alabama [Tuscaloosa] (UA), Section of Rheumatology, The University of Texas Health Science Center at Houston (UTHealth), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Collier, Jean-Yves, Université Catholique de Louvain = Catholic University of Louvain (UCL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Faculté de Médecine ( UPD5 Médecine ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université Paris Descartes - Paris 5 ( UPD5 ), Université Paris Descartes - Paris 5 ( UPD5 ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Division of Clinical Epidemiology ( DCE ), Geneva University Hospital ( HUG ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Université Catholique de Louvain ( UCL ), Harvard Medical School, Boston, The University of Sydney [Sydney], UNIVERSITY OF SOUTHERN DENMARK, University of Alabama [Tuscaloosa] ( UA ), University of Texas at Houston [Houston] ( UTHealth ), and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP]
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Male ,SURGERY ,medicine.medical_treatment ,Arthroplasty, Replacement, Hip ,Osteoarthritis ,Severity of Illness Index ,Osteoarthritis, Hip ,RADIOGRAPHIC FEATURES ,Disability Evaluation ,0302 clinical medicine ,Medicine ,Outpatient clinic ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,PREDICTORS ,Arthroplasty, Replacement, Knee ,Pain Measurement/methods ,Pain/diagnosis ,Pain Measurement ,ddc:616 ,ASSOCIATION ,Osteoarthritis, Knee ,Middle Aged ,3. Good health ,PRIORITIZATION ,TRIALS ,[ SCCO.NEUR ] Cognitive science/Neuroscience ,Female ,Osteoarthritis, Hip/physiopathology/surgery ,musculoskeletal diseases ,medicine.medical_specialty ,Joint replacement ,Symptom ,Decision Making ,Biomedical Engineering ,Pain ,Article ,03 medical and health sciences ,Rheumatology ,Severity of illness ,PHYSICAL-FUNCTION ,Humans ,Knee ,ARTHROPLASTY ,Rheumatology and Autoimmunity ,Aged ,030203 arthritis & rheumatology ,Hip surgery ,Hip ,Osteoarthritis, Knee/physiopathology/surgery ,business.industry ,[SCCO.NEUR]Cognitive science/Neuroscience ,Gold standard ,[SCCO.NEUR] Cognitive science/Neuroscience ,OUTCOME MEASURE ,Knee Hip Osteoarthritis Joint replacement Surgery Symptom radiographic features physical-function outcome measure arthroplasty severity surgery trials prioritization association predictors ,medicine.disease ,Arthroplasty ,SEVERITY ,Cross-Sectional Studies ,Orthopedic surgery ,Physical therapy ,Surgery ,business - Abstract
Import JabRef | WosArea Orthopedics; Rheumatology; International audience; Objective: To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA). Methods: Design: International cross-sectional study in 10 countries. Patients: Consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified. Outcome measures: Pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome Score Physical function Short-form, 0-100). Analyses: Comparison of patients with vs without surgeons' indication for TJR. Receiver Operating Characteristic (ROC) curve analyses and logistic regression were applied to determine cut points of pain and disability defining recommendation for TJR. Results: In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 [standard deviation (SD) 10.9] years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes vs no) had worse symptom levels [pain, 55.5 (95% confidence interval 54.2, 56.8) vs. 44.9 (43.2, 46.6), and functional impairment, 59.8 (58.7, 60.9) vs. 50.9 (49.3, 52.4), respectively, both P inf 0.0001]. there was substantial overlap in symptom levels between groups, even when adjusting for radiographic joint status. Thus, it was not possible to determine cut points for pain and function defining 'requirement for TJR'. Conclusion: Although symptom levels were higher in patients recommended for TJR, pain and functional disability alone did not discriminate between those who were and were not considered to need TJR by the orthopaedic surgeon. (C) 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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- 2011