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Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study.

Publication ,  Journal Article
Riddle, DL; Perera, RA; Stratford, PW; Jiranek, WA; Dumenci, L
Published in: Arthritis Rheum
December 2013

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Duke Scholars

Published In

Arthritis Rheum

DOI

EISSN

1529-0131

Publication Date

December 2013

Volume

65

Issue

12

Start / End Page

3304 / 3313

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Recovery of Function
  • Postoperative Period
  • Pain Measurement
  • Osteoarthritis, Knee
  • Middle Aged
  • Male
  • Knee Joint
  • Humans
  • Female
 

Citation

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Riddle, D. L., Perera, R. A., Stratford, P. W., Jiranek, W. A., & Dumenci, L. (2013). Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study. Arthritis Rheum, 65(12), 3304–3313. https://doi.org/10.1002/art.38139
Riddle, Daniel L., Robert A. Perera, Paul W. Stratford, William A. Jiranek, and Levent Dumenci. “Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study.Arthritis Rheum 65, no. 12 (December 2013): 3304–13. https://doi.org/10.1002/art.38139.
Riddle DL, Perera RA, Stratford PW, Jiranek WA, Dumenci L. Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study. Arthritis Rheum. 2013 Dec;65(12):3304–13.
Riddle, Daniel L., et al. “Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study.Arthritis Rheum, vol. 65, no. 12, Dec. 2013, pp. 3304–13. Pubmed, doi:10.1002/art.38139.
Riddle DL, Perera RA, Stratford PW, Jiranek WA, Dumenci L. Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study. Arthritis Rheum. 2013 Dec;65(12):3304–3313.
Journal cover image

Published In

Arthritis Rheum

DOI

EISSN

1529-0131

Publication Date

December 2013

Volume

65

Issue

12

Start / End Page

3304 / 3313

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Recovery of Function
  • Postoperative Period
  • Pain Measurement
  • Osteoarthritis, Knee
  • Middle Aged
  • Male
  • Knee Joint
  • Humans
  • Female