Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Aug;61(589):e459-68.
doi: 10.3399/bjgp11X588420.

GP referral of patients with osteoarthritis for consideration of total joint replacement: a longitudinal study

Gretl A McHugh  1 , Malcolm Campbell, Karen A Luker
Affiliations

GP referral of patients with osteoarthritis for consideration of total joint replacement: a longitudinal study

Gretl A McHugh et al. Br J Gen Pract. 2011 Aug.

Abstract

Background: Individuals with hip or knee osteoarthritis (OA) are referred to orthopaedic surgeons if considered by their GP as potential candidates for total joint replacement (TJR). It is not clear which patients end up having this surgery.

Aim: The aim of the study was to investigate symptom variation in individuals with OA newly referred by GPs to an orthopaedic surgeon for consideration for TJR, and to determine the predictors of having this procedure.

Design and setting: A longitudinal study of patients at a regional orthopaedic centre with follow-up at 3, 6, and 12 months by postal questionnaire.

Method: GP referrals of patients with OA to orthopaedic surgeons were consecutively sampled. Of the 431 eligible patients, 257 (59.6%) were recruited. Validated measurement tools were used to measure pain, physical functioning, severity of OA, and health-related quality of life.

Results: Over half the participants were in constant pain, taking pain medication more than once per day. Only 67 of 134 (50%) hip and 40 of 123 (33%) knee patients had a TJR within 12 months. Those who had a replacement had been diagnosed with OAfora shorter time, reported more frequent pain, were more likely to use a walking stick, and had worse pain, stiffness, and physical functioning.

Conclusion: Many individuals considered for TJR ultimately may not have surgery, and more effective strategies of management need to be developed between primary and secondary care to achieve better outcomes and to improve quality of care.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Numbers of participants and non-participants during the study.
See this image and copyright information in PMC

References

    1. Birchfield PC. Osteoarthritis overview. Geriatr Nurs. 2001;22(3):124–130. - PubMed
    1. Victor CR, Ross F, Axford J. Capturing lay perspectives in a randomized control trial of a health promotion intervention for people with osteoarthritis of the knee. J Eval Clin Prac. 2004;10(1):63–70. - PubMed
    1. McHugh GA, Luker KA, Campbell M, et al. A longitudinal study exploring pain control, treatment and service provision for individuals with end-stage lower limb osteoarthritis. Rhuematology. 2007;46(4):631–637. - PubMed
    1. Fitzpatrick R, Shortall E, Sculpher M, et al. Primary total hip replacement surgery: a systematic review of outcomes and modelling of cost-effectiveness associated with different prosthesis. Health Technol Assess. 1998;2(20):1–64. - PubMed
    1. Hawker G, Wright J, Coyte P, et al. Health-related quality of life after knee replacement. Results of the knee replacement patient outcomes research team study. J Bone Joint Surg Am. 1998;80(2):163–173. - PubMed

MeSH terms