Factors associated with the orthopaedic surgeon's decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1905 patients

C. Huynh, D. Puyraimond-Zemmour, J. F. Maillefert, P. G. Conaghan, A. M. Davis, K. P. Gunther, G. Hawker, M. C. Hochberg, M. Kloppenburg, K. Lim, L. S. Lohmander, N. N. Mahomed, L. March, K. Pavelka, L. Punzi, E. M. Roos, L. Sanchez-Riera, J. A. Singh, M. E. Suarez-Almazor, M. DougadosL. Gossec*

*Kontaktforfatter for dette arbejde

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Resumé

Objective: To determine factors associated with orthopaedic surgeons’ decision to recommend total joint replacement (TJR) in people with knee and hip osteoarthritis (OA). Design: Cross-sectional study in eleven countries. For consecutive outpatients with definite hip or knee OA consulting an orthopaedic surgeon, the surgeon's indication of TJR was collected, as well as patients’ characteristics including comorbidities and social situation, OA symptom duration, pain, stiffness and function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), joint-specific quality of life, Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) radiographic grade (0–4), and surgeons’ characteristics. Univariable and multivariable logistic regressions were performed to identify factors associated with the indication of TJR, adjusted by country. Results: In total, 1905 patients were included: mean age was 66.5 (standard deviation [SD], 10.8) years, 1082 (58.0%) were women, mean OA symptom duration was 5.0 (SD 7.0) years. TJR was recommended in 561/1127 (49.8%) knee OA and 542/778 (69.7%) hip OA patients. In multivariable analysis on 516 patients with complete data, the variables associated with TJR indication were radiographic grade (Odds Ratio, OR for one grade increase, for knee and hip OA, respectively: 2.90, 95% confidence interval [1.69–4.97] and 3.30 [2.17–5.03]) and WOMAC total score (OR for 10 points increase: 1.65 [1.32–2.06] and 1.38 [1.15–1.66], respectively). After excluding radiographic grade from the analyses, on 1265 patients, greater WOMAC total score was the main predictor for knee and hip OA; older age was also significant for knee OA. Conclusion: Radiographic severity and patient-reported pain and function play a major role in surgeons’ recommendation for TJR.

OriginalsprogEngelsk
TidsskriftOsteoarthritis and Cartilage
Vol/bind26
Udgave nummer10
Sider (fra-til)1311-1318
ISSN1063-4584
DOI
StatusUdgivet - okt. 2018

Fingeraftryk

Hip Osteoarthritis
Knee Osteoarthritis
Orthopedics
Cross-Sectional Studies
Logistics
Stiffness
Joints
Ontario
Orthopedic Surgeons
Comorbidity
Outpatients
Logistic Models
Odds Ratio
Quality of Life
Confidence Intervals
Surgeons

Citer dette

Huynh, C. ; Puyraimond-Zemmour, D. ; Maillefert, J. F. ; Conaghan, P. G. ; Davis, A. M. ; Gunther, K. P. ; Hawker, G. ; Hochberg, M. C. ; Kloppenburg, M. ; Lim, K. ; Lohmander, L. S. ; Mahomed, N. N. ; March, L. ; Pavelka, K. ; Punzi, L. ; Roos, E. M. ; Sanchez-Riera, L. ; Singh, J. A. ; Suarez-Almazor, M. E. ; Dougados, M. ; Gossec, L. / Factors associated with the orthopaedic surgeon's decision to recommend total joint replacement in hip and knee osteoarthritis : an international cross-sectional study of 1905 patients. I: Osteoarthritis and Cartilage. 2018 ; Bind 26, Nr. 10. s. 1311-1318.
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title = "Factors associated with the orthopaedic surgeon's decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1905 patients",
abstract = "Objective: To determine factors associated with orthopaedic surgeons’ decision to recommend total joint replacement (TJR) in people with knee and hip osteoarthritis (OA). Design: Cross-sectional study in eleven countries. For consecutive outpatients with definite hip or knee OA consulting an orthopaedic surgeon, the surgeon's indication of TJR was collected, as well as patients’ characteristics including comorbidities and social situation, OA symptom duration, pain, stiffness and function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), joint-specific quality of life, Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) radiographic grade (0–4), and surgeons’ characteristics. Univariable and multivariable logistic regressions were performed to identify factors associated with the indication of TJR, adjusted by country. Results: In total, 1905 patients were included: mean age was 66.5 (standard deviation [SD], 10.8) years, 1082 (58.0{\%}) were women, mean OA symptom duration was 5.0 (SD 7.0) years. TJR was recommended in 561/1127 (49.8{\%}) knee OA and 542/778 (69.7{\%}) hip OA patients. In multivariable analysis on 516 patients with complete data, the variables associated with TJR indication were radiographic grade (Odds Ratio, OR for one grade increase, for knee and hip OA, respectively: 2.90, 95{\%} confidence interval [1.69–4.97] and 3.30 [2.17–5.03]) and WOMAC total score (OR for 10 points increase: 1.65 [1.32–2.06] and 1.38 [1.15–1.66], respectively). After excluding radiographic grade from the analyses, on 1265 patients, greater WOMAC total score was the main predictor for knee and hip OA; older age was also significant for knee OA. Conclusion: Radiographic severity and patient-reported pain and function play a major role in surgeons’ recommendation for TJR.",
keywords = "Hip, Knee, Osteoarthritis, Surgery, Total joint replacement",
author = "C. Huynh and D. Puyraimond-Zemmour and Maillefert, {J. F.} and Conaghan, {P. G.} and Davis, {A. M.} and Gunther, {K. P.} and G. Hawker and Hochberg, {M. C.} and M. Kloppenburg and K. Lim and Lohmander, {L. S.} and Mahomed, {N. N.} and L. March and K. Pavelka and L. Punzi and Roos, {E. M.} and L. Sanchez-Riera and Singh, {J. A.} and Suarez-Almazor, {M. E.} and M. Dougados and L. Gossec",
year = "2018",
month = "10",
doi = "10.1016/j.joca.2018.06.013",
language = "English",
volume = "26",
pages = "1311--1318",
journal = "Osteoarthritis and Cartilage",
issn = "1063-4584",
publisher = "Elsevier",
number = "10",

}

Huynh, C, Puyraimond-Zemmour, D, Maillefert, JF, Conaghan, PG, Davis, AM, Gunther, KP, Hawker, G, Hochberg, MC, Kloppenburg, M, Lim, K, Lohmander, LS, Mahomed, NN, March, L, Pavelka, K, Punzi, L, Roos, EM, Sanchez-Riera, L, Singh, JA, Suarez-Almazor, ME, Dougados, M & Gossec, L 2018, 'Factors associated with the orthopaedic surgeon's decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1905 patients', Osteoarthritis and Cartilage, bind 26, nr. 10, s. 1311-1318. https://doi.org/10.1016/j.joca.2018.06.013

Factors associated with the orthopaedic surgeon's decision to recommend total joint replacement in hip and knee osteoarthritis : an international cross-sectional study of 1905 patients. / Huynh, C.; Puyraimond-Zemmour, D.; Maillefert, J. F.; Conaghan, P. G.; Davis, A. M.; Gunther, K. P.; Hawker, G.; Hochberg, M. C.; Kloppenburg, M.; Lim, K.; Lohmander, L. S.; Mahomed, N. N.; March, L.; Pavelka, K.; Punzi, L.; Roos, E. M.; Sanchez-Riera, L.; Singh, J. A.; Suarez-Almazor, M. E.; Dougados, M.; Gossec, L.

I: Osteoarthritis and Cartilage, Bind 26, Nr. 10, 10.2018, s. 1311-1318.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Factors associated with the orthopaedic surgeon's decision to recommend total joint replacement in hip and knee osteoarthritis

T2 - an international cross-sectional study of 1905 patients

AU - Huynh, C.

AU - Puyraimond-Zemmour, D.

AU - Maillefert, J. F.

AU - Conaghan, P. G.

AU - Davis, A. M.

AU - Gunther, K. P.

AU - Hawker, G.

AU - Hochberg, M. C.

AU - Kloppenburg, M.

AU - Lim, K.

AU - Lohmander, L. S.

AU - Mahomed, N. N.

AU - March, L.

AU - Pavelka, K.

AU - Punzi, L.

AU - Roos, E. M.

AU - Sanchez-Riera, L.

AU - Singh, J. A.

AU - Suarez-Almazor, M. E.

AU - Dougados, M.

AU - Gossec, L.

PY - 2018/10

Y1 - 2018/10

N2 - Objective: To determine factors associated with orthopaedic surgeons’ decision to recommend total joint replacement (TJR) in people with knee and hip osteoarthritis (OA). Design: Cross-sectional study in eleven countries. For consecutive outpatients with definite hip or knee OA consulting an orthopaedic surgeon, the surgeon's indication of TJR was collected, as well as patients’ characteristics including comorbidities and social situation, OA symptom duration, pain, stiffness and function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), joint-specific quality of life, Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) radiographic grade (0–4), and surgeons’ characteristics. Univariable and multivariable logistic regressions were performed to identify factors associated with the indication of TJR, adjusted by country. Results: In total, 1905 patients were included: mean age was 66.5 (standard deviation [SD], 10.8) years, 1082 (58.0%) were women, mean OA symptom duration was 5.0 (SD 7.0) years. TJR was recommended in 561/1127 (49.8%) knee OA and 542/778 (69.7%) hip OA patients. In multivariable analysis on 516 patients with complete data, the variables associated with TJR indication were radiographic grade (Odds Ratio, OR for one grade increase, for knee and hip OA, respectively: 2.90, 95% confidence interval [1.69–4.97] and 3.30 [2.17–5.03]) and WOMAC total score (OR for 10 points increase: 1.65 [1.32–2.06] and 1.38 [1.15–1.66], respectively). After excluding radiographic grade from the analyses, on 1265 patients, greater WOMAC total score was the main predictor for knee and hip OA; older age was also significant for knee OA. Conclusion: Radiographic severity and patient-reported pain and function play a major role in surgeons’ recommendation for TJR.

AB - Objective: To determine factors associated with orthopaedic surgeons’ decision to recommend total joint replacement (TJR) in people with knee and hip osteoarthritis (OA). Design: Cross-sectional study in eleven countries. For consecutive outpatients with definite hip or knee OA consulting an orthopaedic surgeon, the surgeon's indication of TJR was collected, as well as patients’ characteristics including comorbidities and social situation, OA symptom duration, pain, stiffness and function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), joint-specific quality of life, Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) radiographic grade (0–4), and surgeons’ characteristics. Univariable and multivariable logistic regressions were performed to identify factors associated with the indication of TJR, adjusted by country. Results: In total, 1905 patients were included: mean age was 66.5 (standard deviation [SD], 10.8) years, 1082 (58.0%) were women, mean OA symptom duration was 5.0 (SD 7.0) years. TJR was recommended in 561/1127 (49.8%) knee OA and 542/778 (69.7%) hip OA patients. In multivariable analysis on 516 patients with complete data, the variables associated with TJR indication were radiographic grade (Odds Ratio, OR for one grade increase, for knee and hip OA, respectively: 2.90, 95% confidence interval [1.69–4.97] and 3.30 [2.17–5.03]) and WOMAC total score (OR for 10 points increase: 1.65 [1.32–2.06] and 1.38 [1.15–1.66], respectively). After excluding radiographic grade from the analyses, on 1265 patients, greater WOMAC total score was the main predictor for knee and hip OA; older age was also significant for knee OA. Conclusion: Radiographic severity and patient-reported pain and function play a major role in surgeons’ recommendation for TJR.

KW - Hip

KW - Knee

KW - Osteoarthritis

KW - Surgery

KW - Total joint replacement

U2 - 10.1016/j.joca.2018.06.013

DO - 10.1016/j.joca.2018.06.013

M3 - Journal article

C2 - 30017727

AN - SCOPUS:85050509321

VL - 26

SP - 1311

EP - 1318

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

SN - 1063-4584

IS - 10

ER -