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. 2021 Feb 18:16:257-263.
doi: 10.1016/j.jcot.2021.02.008. eCollection 2021 May.

Risk factors for progression to total knee arthroplasty within two years of presentation for knee osteoarthritis

Justin J Turcotte  1 , McKayla E Kelly  1 , Jacob M Aja  1 , Paul J King  1 , James H MacDonald  1
Affiliations

Risk factors for progression to total knee arthroplasty within two years of presentation for knee osteoarthritis

Justin J Turcotte et al. J Clin Orthop Trauma. .

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Jul 30;20:101539. doi: 10.1016/j.jcot.2021.101539. eCollection 2021 Sep. J Clin Orthop Trauma. 2021. PMID: 34405084 Free PMC article.

Abstract

Introduction: Knee osteoarthritis (OA) is a leading cause of disability and functional limitations in aging adults. Total knee arthroplasty (TKA) is the gold standard treatment of this condition. The purpose of this study is to evaluate which patient characteristics are associated with proceeding to TKA.

Methods: Retrospective review of patients with knee osteoarthritis at a single institution was conducted. Demographic, radiographic and clinical patient characteristics were analyzed. The primary outcome measure was whether patients underwent TKA over the study time-period. Univariate comparisons between patients not undergoing surgery and those undergoing TKA were performed. Multivariate logistic regression was performed to evaluate risk factors for undergoing TKA.

Results: Two hundred seven patients were included in the study. One hundred eighty seven patients (90.3%) did not undergo surgery, while 20 (9.7%) underwent TKA. No statistically significant differences in demographics were observed between patients who underwent TKA and those who did not. On multivariate analysis, patients with Kellgren Lawrence grade 4 OA (OR: 20.793, p = 0.009) and varus alignment (OR: 13.044, p = 0.040) were at significantly increased risk of undergoing TKA. Using only these two variables, the area under the curve for predicting which patients would undergo TKA was 0.846, indicating excellent discrimination.

Conclusion: In patients diagnosed with knee OA, Kellgren Lawrence grade 4 classification and varus knee alignment are significant risk factors for undergoing TKA, and are associated with a decreased time from initial presentation to surgery. These findings may be used to counsel patients, aid triage decisions, and inform the development of future predictive models.

Keywords: Osteoarthritis; Predictive model; Risk factors; Total knee arthroplasty.

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Figures

Fig. 1
Fig. 1
ROC curve analysis: Predictors of surgery.
Fig. 2
Fig. 2
Kaplan Meier survival curve of time to surgery.
Fig. 3
Fig. 3
Kaplan Meier survival estimate of time to surgery by alignment and KL grade.
See this image and copyright information in PMC

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