Dr. Jiranek has received consulting fees, speaking fees, and/or honoraria from DePuy Orthopaedics (less than $10,000), and he receives consulting fees and royalties for hip and knee replacement prostheses from DePuy Orthopaedics.
Progressing Toward, and Recovering From, Knee Replacement Surgery: A Five-Year Cohort Study
Article first published online: 27 NOV 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 65, Issue 12, pages 3304–3313, December 2013
How to Cite
Riddle, D. L., Perera, R. A., Stratford, P. W., Jiranek, W. A. and Dumenci, L. (2013), Progressing Toward, and Recovering From, Knee Replacement Surgery: A Five-Year Cohort Study. Arthritis & Rheumatism, 65: 3304–3313. doi: 10.1002/art.38139
This article was prepared using an Osteoarthritis Initiative (OAI) public-use data set, and its contents do not necessarily reflect the opinions or views of the OAI Study Investigators, the NIH, or the private funding partners of the OAI.
The authors of this article are not part of the OAI investigative team.
- Issue published online: 27 NOV 2013
- Article first published online: 27 NOV 2013
- Accepted manuscript online: 27 AUG 2013 03:32PM EST
- Manuscript Accepted: 13 AUG 2013
- Manuscript Received: 28 FEB 2013
- The OAI is a public–private partnership between the NIH. Grant Numbers: N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, N01-AR-2-2262
- Merck Research Laboratories
- Novartis Pharmaceuticals
- Pfizer, Inc.
- OAI Study Investigators
To determine the trajectories of preoperative worsening and postoperative recovery for both the index knee and the contralateral knee of patients undergoing knee replacement surgery.
Of the 4,796 subjects in the Osteoarthritis Initiative cohort study database, we examined 5-year data from 177 patients who underwent isolated unilateral knee replacement surgery and no other joint replacement surgery. Patient-reported outcomes captured domains defined by the International Classification of Functioning, Disability, and Health. Domains of knee structure and function, activity limitation, and participation restriction were examined using growth-curve modeling over 5-year periods prior to and following surgery.
Preoperative worsening of the index knee was substantial in all domains of knee impairment, activity limitation, and societal participation. Pain intensity worsened only slightly from 5 years to 2.5 years prior to surgery, but worsened by ∼2 points (0–10-point scale) during the 2.5 years prior to surgery. Trajectories of improvement following surgery varied depending on the outcome measure. The contralateral knee also changed over time, such that by ∼2 years following surgery, pain was worse and by 3 years, activity limitation was worse in the contralateral knee as compared to the index knee.
Patients who elect to undergo knee replacement surgery demonstrate perioperative trajectories of change that influence most health domains for both the index knee and the contralateral knee. After a period of no change, escalation of pain and worsening functioning in the index knee begins ∼2.5 years prior to surgery, which may be a key trigger for surgery.