Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years
arthroplasty; hip; knee; osteoarthritis; quality of life
Abstract :
[en] Objectives: To study and identify the determinants of the impact on pain, function, and quality of life of a prosthetic replacement surgery after 5 years of survival in patients with osteoarthritis (OA) of the lower limb.
Method: In total, 626 osteoarthritic patients from a University Hospital, divided in 2 groups (according to surgical site), were prospectively followed for 5 years after hip (n = 346) or knee (n = 280) replacement. Validated specific Western Ontario and McMaster Universities Arthritis Index (WOMAC) and generic (SF-36 and EQ) instruments assessing quality of life were used prior to surgery and yearly, thereafter. We defined a good outcome as a clinically relevant improvement in WOMAC greater than or equal to the minimally important difference (MID). Régressions showed the relationships among preoperative, perioperative, and postoperative measures and the evolution of WOMAC scores after 5 years (percent change). We also examined any predictors of good outcomes.
Results: The beneficial effect on quality of life observed during the first year after hip and knee arthroplasty (HA and KA) was maintained for up to 5 years. More than 3/4 of the patients in our study experienced a good outcome (86.04% in HA group and 79.91% inKA group). Both the good outcome and the 5-year change inWOMAC are predicted by preoperative (i.e., radiological
severity, comorbidities, disability, and level of education), perioperative (i.e., length of hospital stay and place of discharge), and postoperative (i.e., complications) variables in the two groups.
Conclusions: Joint arthroplasty is a highly valuable therapeutic strategy for hip or knee OA patients who do not respond to pharmacological management. These results represent a step towards the collection of robust, scientifically sound data that will facilitate the completion of health economic analyses in the field of OA.
Disciplines :
General & internal medicine Surgery
Author, co-author :
Neuprez, Audrey ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Neuprez, Arnaud ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
KAUX, Jean-François ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service de médecine de l'appareil locomoteur
KURTH, William ; Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Service de chirurgie de l'appareil locomoteur
DANIEL, Christophe ; Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Service de chirurgie de l'appareil locomoteur
THIRION, Thierry ; Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Service de chirurgie de l'appareil locomoteur
Hustin, Jean-Pierre
Gillet, Philippe ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgie de l'appareil locomoteur
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Total joint replacement improves pain, functional quality of life, and health utilities in patients with late-stage knee and hip osteoarthritis for up to 5 years
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