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.
Better Functional and Similar Pain Outcomes in Osteoarthritis Compared to Rheumatoid Arthritis After Primary Total Knee Arthroplasty: A Cohort Study
Article first published online: 27 NOV 2013
Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
Arthritis Care & Research
Volume 65, Issue 12, pages 1936–1941, December 2013
How to Cite
Singh, J. A. and Lewallen, D. G. (2013), Better Functional and Similar Pain Outcomes in Osteoarthritis Compared to Rheumatoid Arthritis After Primary Total Knee Arthroplasty: A Cohort Study. Arthritis Care Res, 65: 1936–1941. doi: 10.1002/acr.22090
- Issue published online: 27 NOV 2013
- Article first published online: 27 NOV 2013
- Accepted manuscript online: 7 AUG 2013 12:43PM EST
- Manuscript Accepted: 15 JUL 2013
- Manuscript Received: 11 FEB 2013
- Mayo Clinic Orthopedic Surgery research funds
- Resources and use of facilities at the Birmingham VA Medical Center, Alabama
- Agency for Health Quality and Research Center for Education and Research on Therapeutics
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- National Institute of Aging
- National Cancer Institute
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).
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).
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).
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.