Outcomes of total hip and knee replacement: Preoperative functional status predicts outcomes at six months after surgery
Article first published online: 26 APR 2001
Copyright © 1999 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 42, Issue 8, pages 1722–1728, August 1999
How to Cite
Fortin, P. R., Clarke, A. E., Joseph, L., Liang, M. H., Tanzer, M., Ferland, D., Phillips, C., Partridge, A. J., Bélisle, P., Fossel, A. H., Mahomed, N., Sledge, C. B. and Katz, J. N. (1999), Outcomes of total hip and knee replacement: Preoperative functional status predicts outcomes at six months after surgery. Arthritis & Rheumatism, 42: 1722–1728. doi: 10.1002/1529-0131(199908)42:8<1722::AID-ANR22>3.0.CO;2-R
- Issue published online: 26 APR 2001
- Article first published online: 26 APR 2001
- Manuscript Accepted: 22 APR 1999
- Manuscript Received: 26 FEB 1999
- “Hip, Hip, Hooray” grant from the Canadian Orthopaedic Foundation
- NIH. Grant Number: AR-36308
- Chercheur Boursier Programme of the Fonds de la Recherche en Santé du Québec
- Arthritis Foundation
To determine whether patients with knee or hip osteoarthritis (OA) who have worse physical function preoperatively achieve a postoperative status that is similar to that of patients with better preoperative function.
This study surveyed an observational cohort of 379 consecutive patients with definite OA who were without other inflammatory joint diseases and were undergoing either total hip or knee replacement in a US (Boston) and a Canadian (Montreal) referral center. Questionnaires on health status (the Short Form 36 and Western Ontario and McMaster Universities Osteoarthritis Index) were administered preoperatively and at 3 and 6 months postoperatively. Physical function and pain due to OA were deemed the most significant outcomes to study.
Two hundred twenty-two patients returned their questionnaires. Patients in the 2 centers were comparable in age, sex, time to surgery, and proportion of hip/knee surgery. The Boston group had more education, lower comorbidity, and more cemented knee prostheses. Patients undergoing hip or knee replacement in Montreal had lower preoperative physical function and more pain than their Boston counterparts. In patients with lower preoperative physical function, function and pain were not improved postoperatively to the level achieved by those with higher preoperative function. This was most striking in patients undergoing total knee replacement.
Surgery performed later in the natural history of functional decline due to OA of the knee, and possibly of the hip, results in worse postoperative functional status.