FUNCTIONAL OUTCOME & PATIENT FACTORS
TIMING OF SURGERY, PREOPERATIVE FUNCTION AND POSTOPERATIVE OUTCOME
1. Preoperative function and gender predict pattern of functional recovery after hip and knee arthroplasty.
J Arthroplasty. 2006 Jun;21(4):559-
Kennedy DM, Hanna SE, Stratford PW, Wessel J, Gollish JD.
Gender, preoperative function, and other variables were explored as predictors of recovery after total hip and knee arthroplasty. One hundred fifty-
2. Determinants of the subjective functional outcome of total joint arthroplasty.
Arch Gerontol Geriatr. 2005 Sep-
Caracciolo B, Giaquinto S.
The aim of the study is three-
3. Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee.
Arthritis Rheum. 2002 Dec;46(12):3327-
Fortin PR, Penrod JR, Clarke AE, St-
OBJECTIVE: To determine the predictors of outcome in patients with osteoarthritis 2 years after receiving total hip or knee replacement. METHODS: A prospective cohort study of 222 osteoarthritis patients undergoing total hip or knee replacement in Boston and Montreal was done. Their postoperative outcomes at 6 months were previously reported. This followup reports on the outcomes after 2 years among the 165 patients (74%) who remained. The subjects were divided into 2 groups according to the median value of their preoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score. The Short Form 36-
4. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery.
Arthritis Rheum. 1999 Aug;42(8):1722-
Fortin PR, Clarke AE, Joseph L, Liang MH, Tanzer M, Ferland D, Phillips C, Partridge AJ, Bélisle P, Fossel AH, Mahomed N, Sledge CB, Katz JN.
OBJECTIVE: To determine whether patients with knee or hip osteoarthritis (OA) who have worse physical function preoperatively achieve a postoperative status that is similar to that of patients with better preoperative function. METHODS: This study surveyed an observational cohort of 379 consecutive patients with definite OA who were without other inflammatory joint diseases and were undergoing either total hip or knee replacement in a US (Boston) and a Canadian (Montreal) referral center. Questionnaires on health status (the Short Form 36 and Western Ontario and McMaster Universities Osteoarthritis Index) were administered preoperatively and at 3 and 6 months postoperatively. Physical function and pain due to OA were deemed the most significant outcomes to study. RESULTS: Two hundred twenty-
5. Predicting the outcome of total knee arthroplasty.
J Bone Joint Surg Am. 2004 Oct;86-
Lingard EA, Katz JN, Wright EA, Sledge CB; Kinemax Outcomes Group.
BACKGROUND: The relief of pain and the restoration of functional activities are the main outcomes of primary total knee arthroplasty for the treatment of osteoarthritis. This paper examines the preoperative predictors of pain and functional outcome at one and two years following total knee arthroplasty. METHODS: Patients were recruited for a prospective observational study of primary total knee arthroplasty for the treatment of osteoarthritis from centers in the United States, the United Kingdom, and Australia. Research assistants recruited the patients and collected the clinical history and physical examination data preoperatively and at three, twelve, and twenty-
1. Total hip and knee arthroplasty in nonagenarians.
J Arthroplasty. 2007 Sep;22(6):807-
Alfonso DT, Howell RD, Strauss EJ, Di Cesare PE.
Among 25 patients of mean age 91.5 years (range, 90-
1. The impact of tobacco use and body mass index on the length of stay in hospital and the risk of post-
operative complications among patients undergoing total hip replacement.
J Bone Joint Surg Br. 2006 Oct;88(10):1316-
Sadr Azodi O, Bellocco R, Eriksson K, Adami J.
We carried out a retrospective cohort study of 3309 patients undergoing primary total hip replacement to examine the impact of tobacco use and body mass index on the length of stay in hospital and the risk of short term post-
increased by 58% in the obese. Smoking and body mass index were not significantly related to the development of local complications. Greater efforts should be taken to reduce the impact of preventable life style factors, such as smoking and high body mass index, on the post-
2. Obesity and perioperative morbidity in total hip and total knee arthroplasty patients.
J Arthroplasty. 2005 Oct;20(7 Suppl 3):46-
Namba RS, Paxton L, Fithian DC, Stone ML.
The incidence of obesity in 1071 total hip arthroplasty (THA) patients and 1813 total knee arthroplasty (TKA) patients and its effect on perioperative morbidity were evaluated prospectively. Fifty-
patients undergoing total joint arthroplasty must be realized by both the patient and surgeon.
3. High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years.
Acta Orthop. 2008 Feb;79(1):141-
Sadr Azodi O, Adami J, Lindström D, Eriksson KO, Wladis A, Bellocco R.
BACKGROUND AND PURPOSE: Implant dislocation is one of the commonest complications following primary total hip replacement (THR). We investigated the effect of body mass index (BMI) and tobacco use on the risk of this complication. SUBJECTS AND METHODS: Through linkage between the Swedish Construction Workers’ cohort and the Swedish Inpatient Register, 2,106 male patients who had undergone primary THR between 1997 and 2004 were identified. We used Cox multivariable regression analysis to study the association between BMI and tobacco use and the risk of implant dislocation. RESULTS: 53 patients (2.5%) developed implant dislocation during a mean of 2 (0-
4. Effect of smoking on early complications after elective orthopaedic surgery.
J Bone Joint Surg Br. 2003 Mar;85(2):178-
Møller AM, Pedersen T, Villebro N, Munksgaard A.
Smoking is an important risk factor for the development of postoperative pulmonary complications after major surgical procedures. We studied 811 consecutive patients who had undergone hip or knee arthroplasty, recording current smoking and drinking habits, any history of chronic disease and such intraoperative factors as the type of anaesthesia and the type and duration of surgery. We recorded any postoperative complications occurring before discharge from hospital. There were 232 smokers (28.6%) and 579 non-
5. Obese diabetic patients are at substantial risk for deep infection after primary TKA.
Clin Orthop Relat Res. 2009 Jun;467(6):1577-
Dowsey MM, Choong PF.
We conducted a prospective study of 1214 consecutive primary TKAs to compare the deep prosthetic infection rate between obese and nonobese patients during the first 12 months after surgery. We also sought to determine whether patient or surgical variables such as comorbidities, age, gender, blood transfusion, use of surgical drains, and antibiotic-
However some other studies suggest obese patients also get functional benefit following arthroplasty. On balance, it would be appropriate to reduce the risk factors as much as possible prior to joint replacement.