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
Comparative Study
. 2016 Feb;87(1):67-71.
doi: 10.3109/17453674.2015.1092369. Epub 2015 Oct 20.

Outcome of total hip arthroplasty, but not of total knee arthroplasty, is related to the preoperative radiographic severity of osteoarthritis. A prospective cohort study of 573 patients

Claire Tilbury  1 , Maarten J Holtslag  1 , Rutger L Tordoir  2 , Claudia S Leichtenberg  1 , Suzan H M Verdegaal  2 , Herman M Kroon  3 , Marta Fiocco  4 , Rob G H H Nelissen  1 , Thea P M Vliet Vlieland  1
Affiliations
Comparative Study

Outcome of total hip arthroplasty, but not of total knee arthroplasty, is related to the preoperative radiographic severity of osteoarthritis. A prospective cohort study of 573 patients

Claire Tilbury et al. Acta Orthop. 2016 Feb.

Abstract

Background and purpose: There is no consensus on the impact of radiographic severity of hip and knee osteoarthritis (OA) on the clinical outcome of total hip arthroplasty (THA) and total knee arthroplasty (TKA). We assessed whether preoperative radiographic severity of OA is related to improvements in functioning, pain, and health-related quality of life (HRQoL) 1 year after THA or TKA.

Patients and methods: This prospective cohort study included 302 THA patients and 271 TKA patients with hip or knee OA. In the THA patients, preoperatively 26% had mild OA and 74% had severe OA; in the TKA patients, preoperatively 27% had mild OA and 73% had severe OA. Radiographic severity was determined according to the Kellgren and Lawrence (KL) classification. Clinical assessments preoperatively and 1 year postoperatively included: sociodemographic characteristics and patient-reported outcomes (PROMs): Oxford hip/knee score, hip/knee injury and osteoarthritis outcome score (HOOS/KOOS), SF36, and EQ5D. Change scores of PROMs were compared with mild OA (KL 0-2) and severe OA (KL 3-4) using a multivariate linear regression model.

Results: Adjusted for sex, age, preoperative scores, BMI, and Charnley score, radiographic severity of OA in THA was associated with improvement in HOOS "Activities of daily living", "Pain", and "Symptoms", and SF36 physical component summary ("PCS") scale. In TKA, we found no such associations.

Interpretation: The decrease in pain and improvement in function in THA patients, but not in TKA patients, was positively associated with the preoperative radiographic severity of OA.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow diagram. aReasons for exclusion were patients who did not understand Dutch or were physically or mentally unable to complete questionnaires, patients with revision surgery, undergoing a hemi-arthroplasty, or undergoing THA or TKA because of a tumor or rheumatoid arthritis.
See this image and copyright information in PMC

Comment in

References

    1. Aaronson N K, Muller M, Cohen P D, Essink-Bot M L, Fekkes M, Sanderman R, Sprangers M A, te V A, Verrips E.. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 1998; 51(11): 1055-68. - PubMed
    1. Beswick A D, Wylde V, Gooberman-Hill R, Blom A, Dieppe P.. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2012; 2(1): e000435. - PMC - PubMed
    1. Clement N D, MacDonald D, Simpson A H.. The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2014; 22(8): 1933-9. - PubMed
    1. Cushnaghan J, Bennett J, Reading I, Croft P, Byng P, Cox K, Dieppe P, Coggon D, Cooper C.. Long-term outcome following total knee arthroplasty: a controlled longitudinal study. Ann Rheum Dis 2009; 68(5): 642-7. - PubMed
    1. Dawson J, Fitzpatrick R, Carr A, Murray D.. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br 1996; 78(2): 185-90. - PubMed

Publication types

MeSH terms

LinkOut - more resources