Better Functional and Similar Pain Outcomes in Osteoarthritis Compared to Rheumatoid Arthritis After Primary Total Knee Arthroplasty: A Cohort Study

Authors

  • Jasvinder A. Singh,

    Corresponding author
    1. Birmingham VA Medical Center and University of Alabama at Birmingham, and Mayo Clinic College of Medicine, Rochester, Minnesota
    • University of Alabama, Faculty Office Tower 805B, 510 20th Street South, Birmingham, AL 35294. E-mail: Jasvinder.md@gmail.com

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    • Dr. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Regeneron, and Savient and (more than $10,000) from Takeda, and has received research and travel grants from Takeda and Savient.

  • David G. Lewallen

    1. Mayo Clinic College of Medicine, Rochester, Minnesota
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    • Dr. Lewallen has received consultant fees, speaking fees, and/or honoraria (more than $10,000 each) from Zimmer, Orthosonic, and Osteotech, owns stock or stock options in Pipeline Biomedical, holds a patent or license from Zimmer and receives royalties from Zimmer, Orthosonic, and Osteotech for hip and knee implants, and his institution has received research funds from DePuy, Stryker, Biomet, and Zimmer.


Abstract

Objective

To determine the association of the underlying diagnosis with limitation in activities of daily living (ADL) and pain in patients undergoing primary total knee arthroplasty (TKA).

Methods

Prospectively collected data from the Mayo Clinic Total Joint Registry were used to assess the association of diagnosis with moderate–severe limitation in ADL and moderate–severe pain at 2 and 5 years after primary TKA, using multivariable-adjusted logistic regression analyses. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs).

Results

There were 7,139 primary TKAs at 2 years and 4,234 at 5 years. In multivariable-adjusted analyses, compared with rheumatoid arthritis (RA)/inflammatory arthritis, osteoarthritis (OA) was associated with significantly lower moderate–severe ADL limitation at 2 years (OR 0.5 [95% CI 0.3–0.8]) (P = 0.004) and at 5 years (OR 0.5 [95% CI 0.3–0.9]) (P = 0.02). There was no significant association of diagnosis of OA with moderate–severe pain at 2 years (OR 1.2 [95% CI 0.5–2.7]) (P = 0.68) or at 5 years (OR 1.0 [95% CI 0.3–3.7]) (P = 1.0).

Conclusion

We found that patients with OA who underwent primary TKA had better ADL outcomes compared to patients with RA/inflammatory arthritis at 2 and 5 years. On the other hand, the pain outcomes after primary TKA did not differ in OA versus RA. This suggests a discordant effect of underlying diagnosis on pain and function outcomes after TKA. These novel findings can be used to better inform both patients and surgeons about expected pain and function outcomes after primary TKA.

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