The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement

被引：148

作者：

Gossec, L. ^{[1
]}

Paternotte, S.

Maillefert, J. F. ^{[2
,3
,4
]}

Combescure, C. ^{[5
]}

Conaghan, P. G. ^{[6
,7
]}

Davis, A. M. ^{[8
,9
,10
,11
]}

Gunther, K. -P. ^{[12
]}

Hawker, G. ^{[13
,14
]}

Hochberg, M. ^{[15
,16
]}

Katz, J. N. ^{[17
,18
,19
]}

Kloppenburg, M. ^{[20
,21
]}

Lim, K. ^{[22
,23
]}

Lohmander, L. S. ^{[24
]}

Mahomed, N. N. ^{[25
]}

March, L. ^{[26
]}

Pavelka, K. ^{[27
]}

Punzi, L. ^{[28
]}

Roos, E. M. ^{[29
]}

Sanchez-Riera, L. ^{[30
]}

Singh, J. A. ^{[31
,32
]}

Suarez-Almazor, M. E. ^{[33
]}

Dougados, M.

机构：

[1] Paris Descartes Univ, Hop Cochin, APHP, Fac Med,Rheumatol Dept B,Serv Rhumatol B, F-75014 Paris, France

[2] Dijon Univ Hosp, Dept Rheumatol, F-21078 Dijon, France

[3] Univ Burgundy, F-21079 Dijon, France

[4] INSERM, U887, F-21079 Dijon, France

[5] Univ Geneva, CH-1211 Geneva 4, Switzerland

[6] Univ Leeds, Sect Musculoskeletal Dis, Leeds, W Yorkshire, England

[7] NIHR Leeds Musculoskeletal Biomed Res Unit, Leeds, W Yorkshire, England

[8] Toronto Western Res Inst, Div Hlth Care & Outcomes Res & Arthrit, Toronto, ON, Canada

[9] Toronto Western Res Inst, Community Res & Evaluat Unit, Toronto, ON, Canada

[10] Univ Toronto, Dept Rehabil Sci, Toronto, ON M5S 1A1, Canada

[11] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON M5S 1A1, Canada

[12] Univ Dresden, Dept Orthopaed Surg, Dresden, Germany

[13] Univ Toronto, Div Rheumatol, Dept Med, Womens Coll Hosp, Toronto, ON M5S 1A1, Canada

[14] Univ Toronto, Clin Epidemiol & Hlth Care Res Program, Dept Hlth Policy Management & Evaluat, Fac Med, Toronto, ON M5S 1A1, Canada

[15] Univ Maryland, Sch Med, Dept Med, Div Rheumatol & Clin Immunol, Baltimore, MD 21201 USA

[16] Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, Div Gerontol, Baltimore, MD 21201 USA

[17] Harvard Univ, Sch Med, Dept Orthoped Surg, Boston, MA 02115 USA

[18] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA

[19] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA

[20] Leiden Univ Med Ctr, Dept Rheumatol, Leiden, Netherlands

[21] Leiden Univ Med Ctr, Dept Clin Epidemiol, Leiden, Netherlands

[22] St Vincents Hosp, Dept Rheumatol, Melbourne, Vic, Australia

[23] Western Hosp, Melbourne, Vic, Australia

[24] Lund Univ, Dept Orthopaed, Lund, Sweden

[25] Univ Toronto, Toronto Western Hosp, Div Orthopaed Surg, Toronto, ON M5T 2S8, Canada

[26] Univ Sydney, Royal N Shore Hosp, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia

[27] Charles Univ Prague, Inst Rheumatol, CR-11636 Prague 1, Czech Republic

[28] Univ Padua, Rheumatol Unit, Dept Clin & Expt Med, I-35100 Padua, Italy

[29] Univ So Denmark, Inst Sports & Clin Biomech, Odense, Denmark

[30] Univ Sydney, Inst Bone & Joint Res, Sydney, NSW 2006, Australia

[31] Birmingham VA Med Ctr, Birmingham, AL USA

[32] Univ Alabama Birmingham, Birmingham, AL USA

[33] Univ Texas MD Anderson Canc Ctr, Rheumatol Sect, Houston, TX 77030 USA

来源：

OSTEOARTHRITIS AND CARTILAGE | 2011年 / 19卷 / 02期

关键词：

Knee; Hip; Osteoarthritis; Joint replacement; Surgery; Symptom; RADIOGRAPHIC FEATURES; PHYSICAL-FUNCTION; OUTCOME MEASURE; ARTHROPLASTY; SEVERITY; PRIORITIZATION; ASSOCIATION; PREDICTORS; CRITERIA; TRIALS;

D O I：

10.1016/j.joca.2010.10.025

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Objective: To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA). Methods: Design: International cross-sectional study in 10 countries. Patients: Consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified. Outcome measures: Pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome Score Physical function Short-form, 0-100). Analyses: Comparison of patients with vs without surgeons' indication for TJR. Receiver Operating Characteristic (ROC) curve analyses and logistic regression were applied to determine cut points of pain and disability defining recommendation for TJR. Results: In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 [standard deviation (SD) 10.9] years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes vs no) had worse symptom levels [pain, 55.5 (95% confidence interval 54.2, 56.8) vs. 44.9 (43.2, 46.6), and functional impairment, 59.8 (58.7, 60.9) vs. 50.9 (49.3, 52.4), respectively, both P < 0.0001]. there was substantial overlap in symptom levels between groups, even when adjusting for radiographic joint status. Thus, it was not possible to determine cut points for pain and function defining 'requirement for TJR'. Conclusion: Although symptom levels were higher in patients recommended for TJR, pain and functional disability alone did not discriminate between those who were and were not considered to need TJR by the orthopaedic surgeon. (C) 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

引用

页码：147 / 154

页数：8

共 42 条

[1] Variation in Age and Physical Status Prior to Total Knee and Hip Replacement Surgery: A Comparison of Centers in Australia and Europe [J].