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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">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</title>
<author><name sortKey="Gossec, Laure" sort="Gossec, Laure" uniqKey="Gossec L" first="Laure" last="Gossec">Laure Gossec</name>
</author>
<author><name sortKey="Paternotte, Simon" sort="Paternotte, Simon" uniqKey="Paternotte S" first="Simon" last="Paternotte">Simon Paternotte</name>
</author>
<author><name sortKey="Maillefert, Jean Francis" sort="Maillefert, Jean Francis" uniqKey="Maillefert J" first="Jean Francis" last="Maillefert">Jean Francis Maillefert</name>
</author>
<author><name sortKey="Combescure, Christophe" sort="Combescure, Christophe" uniqKey="Combescure C" first="Christophe" last="Combescure">Christophe Combescure</name>
</author>
<author><name sortKey="Conaghan, Philip G" sort="Conaghan, Philip G" uniqKey="Conaghan P" first="Philip G" last="Conaghan">Philip G. Conaghan</name>
</author>
<author><name sortKey="Davis, Aileen M" sort="Davis, Aileen M" uniqKey="Davis A" first="Aileen M." last="Davis">Aileen M. Davis</name>
</author>
<author><name sortKey="Gunther, Klaus Peter" sort="Gunther, Klaus Peter" uniqKey="Gunther K" first="Klaus-Peter" last="Gunther">Klaus-Peter Gunther</name>
</author>
<author><name sortKey="Hawker, Gillian" sort="Hawker, Gillian" uniqKey="Hawker G" first="Gillian" last="Hawker">Gillian Hawker</name>
</author>
<author><name sortKey="Hochberg, Marc" sort="Hochberg, Marc" uniqKey="Hochberg M" first="Marc" last="Hochberg">Marc Hochberg</name>
</author>
<author><name sortKey="Katz, Jeffrey N" sort="Katz, Jeffrey N" uniqKey="Katz J" first="Jeffrey N" last="Katz">Jeffrey N. Katz</name>
</author>
<author><name sortKey="Kloppenburg, Margreet" sort="Kloppenburg, Margreet" uniqKey="Kloppenburg M" first="Margreet" last="Kloppenburg">Margreet Kloppenburg</name>
</author>
<author><name sortKey="Lim, Keith" sort="Lim, Keith" uniqKey="Lim K" first="Keith" last="Lim">Keith Lim</name>
</author>
<author><name sortKey="Lohmander, L Stefan" sort="Lohmander, L Stefan" uniqKey="Lohmander L" first="L. Stefan" last="Lohmander">L. Stefan Lohmander</name>
</author>
<author><name sortKey="Mahomed, Nizar N" sort="Mahomed, Nizar N" uniqKey="Mahomed N" first="Nizar N." last="Mahomed">Nizar N. Mahomed</name>
</author>
<author><name sortKey="March, Lyn" sort="March, Lyn" uniqKey="March L" first="Lyn" last="March">Lyn March</name>
</author>
<author><name sortKey="Pavelka, Karel" sort="Pavelka, Karel" uniqKey="Pavelka K" first="Karel" last="Pavelka">Karel Pavelka</name>
</author>
<author><name sortKey="Punzi, Leonardo" sort="Punzi, Leonardo" uniqKey="Punzi L" first="Leonardo" last="Punzi">Leonardo Punzi</name>
</author>
<author><name sortKey="Roos, Ewa M" sort="Roos, Ewa M" uniqKey="Roos E" first="Ewa M." last="Roos">Ewa M. Roos</name>
</author>
<author><name sortKey="Sanchez Riera, Lydia" sort="Sanchez Riera, Lydia" uniqKey="Sanchez Riera L" first="Lydia" last="Sanchez-Riera">Lydia Sanchez-Riera</name>
</author>
<author><name sortKey="Singh, Jasvinder A" sort="Singh, Jasvinder A" uniqKey="Singh J" first="Jasvinder A." last="Singh">Jasvinder A. Singh</name>
</author>
<author><name sortKey="Suarez Almazor, Maria E" sort="Suarez Almazor, Maria E" uniqKey="Suarez Almazor M" first="Maria E." last="Suarez-Almazor">Maria E. Suarez-Almazor</name>
</author>
<author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">21044689</idno>
<idno type="pmc">4151518</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151518</idno>
<idno type="RBID">PMC:4151518</idno>
<idno type="doi">10.1016/j.joca.2010.10.025</idno>
<date when="2010">2010</date>
<idno type="wicri:Area/Pmc/Corpus">002160</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002160</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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</title>
<author><name sortKey="Gossec, Laure" sort="Gossec, Laure" uniqKey="Gossec L" first="Laure" last="Gossec">Laure Gossec</name>
</author>
<author><name sortKey="Paternotte, Simon" sort="Paternotte, Simon" uniqKey="Paternotte S" first="Simon" last="Paternotte">Simon Paternotte</name>
</author>
<author><name sortKey="Maillefert, Jean Francis" sort="Maillefert, Jean Francis" uniqKey="Maillefert J" first="Jean Francis" last="Maillefert">Jean Francis Maillefert</name>
</author>
<author><name sortKey="Combescure, Christophe" sort="Combescure, Christophe" uniqKey="Combescure C" first="Christophe" last="Combescure">Christophe Combescure</name>
</author>
<author><name sortKey="Conaghan, Philip G" sort="Conaghan, Philip G" uniqKey="Conaghan P" first="Philip G" last="Conaghan">Philip G. Conaghan</name>
</author>
<author><name sortKey="Davis, Aileen M" sort="Davis, Aileen M" uniqKey="Davis A" first="Aileen M." last="Davis">Aileen M. Davis</name>
</author>
<author><name sortKey="Gunther, Klaus Peter" sort="Gunther, Klaus Peter" uniqKey="Gunther K" first="Klaus-Peter" last="Gunther">Klaus-Peter Gunther</name>
</author>
<author><name sortKey="Hawker, Gillian" sort="Hawker, Gillian" uniqKey="Hawker G" first="Gillian" last="Hawker">Gillian Hawker</name>
</author>
<author><name sortKey="Hochberg, Marc" sort="Hochberg, Marc" uniqKey="Hochberg M" first="Marc" last="Hochberg">Marc Hochberg</name>
</author>
<author><name sortKey="Katz, Jeffrey N" sort="Katz, Jeffrey N" uniqKey="Katz J" first="Jeffrey N" last="Katz">Jeffrey N. Katz</name>
</author>
<author><name sortKey="Kloppenburg, Margreet" sort="Kloppenburg, Margreet" uniqKey="Kloppenburg M" first="Margreet" last="Kloppenburg">Margreet Kloppenburg</name>
</author>
<author><name sortKey="Lim, Keith" sort="Lim, Keith" uniqKey="Lim K" first="Keith" last="Lim">Keith Lim</name>
</author>
<author><name sortKey="Lohmander, L Stefan" sort="Lohmander, L Stefan" uniqKey="Lohmander L" first="L. Stefan" last="Lohmander">L. Stefan Lohmander</name>
</author>
<author><name sortKey="Mahomed, Nizar N" sort="Mahomed, Nizar N" uniqKey="Mahomed N" first="Nizar N." last="Mahomed">Nizar N. Mahomed</name>
</author>
<author><name sortKey="March, Lyn" sort="March, Lyn" uniqKey="March L" first="Lyn" last="March">Lyn March</name>
</author>
<author><name sortKey="Pavelka, Karel" sort="Pavelka, Karel" uniqKey="Pavelka K" first="Karel" last="Pavelka">Karel Pavelka</name>
</author>
<author><name sortKey="Punzi, Leonardo" sort="Punzi, Leonardo" uniqKey="Punzi L" first="Leonardo" last="Punzi">Leonardo Punzi</name>
</author>
<author><name sortKey="Roos, Ewa M" sort="Roos, Ewa M" uniqKey="Roos E" first="Ewa M." last="Roos">Ewa M. Roos</name>
</author>
<author><name sortKey="Sanchez Riera, Lydia" sort="Sanchez Riera, Lydia" uniqKey="Sanchez Riera L" first="Lydia" last="Sanchez-Riera">Lydia Sanchez-Riera</name>
</author>
<author><name sortKey="Singh, Jasvinder A" sort="Singh, Jasvinder A" uniqKey="Singh J" first="Jasvinder A." last="Singh">Jasvinder A. Singh</name>
</author>
<author><name sortKey="Suarez Almazor, Maria E" sort="Suarez Almazor, Maria E" uniqKey="Suarez Almazor M" first="Maria E." last="Suarez-Almazor">Maria E. Suarez-Almazor</name>
</author>
<author><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name>
</author>
</analytic>
<series><title level="j">Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society</title>
<idno type="ISSN">1063-4584</idno>
<idno type="eISSN">1522-9653</idno>
<imprint><date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2"><italic>Design</italic>
: international cross-sectional study in 10 countries. <italic>Patients:</italic>
consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. <italic>Gold standard measure for recommendation for TJR</italic>
: surgeon's decision that TJR is justified. <italic>Outcome measures:</italic>
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). <italic>Analyses</italic>
: Comparison of patients with versus without surgeons' indication for TJR. ROC curve analyses and logistic regression were applied to determine cut-points of pain and disability defining recommendation for TJR.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 (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 versus 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’.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">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.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9305697</journal-id>
<journal-id journal-id-type="pubmed-jr-id">8786</journal-id>
<journal-id journal-id-type="nlm-ta">Osteoarthritis Cartilage</journal-id>
<journal-id journal-id-type="iso-abbrev">Osteoarthr. Cartil.</journal-id>
<journal-title-group><journal-title>Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society</journal-title>
</journal-title-group>
<issn pub-type="ppub">1063-4584</issn>
<issn pub-type="epub">1522-9653</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21044689</article-id>
<article-id pub-id-type="pmc">4151518</article-id>
<article-id pub-id-type="doi">10.1016/j.joca.2010.10.025</article-id>
<article-id pub-id-type="manuscript">NIHMS604592</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>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</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Gossec</surname>
<given-names>Laure</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A1">Paris Descartes University, Medicine Faculty; APHP, Rheumatology B Department, Cochin Hospital, Paris France</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Paternotte</surname>
<given-names>Simon</given-names>
</name>
<degrees>MSc</degrees>
<aff id="A2">Paris Descartes University, Medicine Faculty; APHP, Rheumatology B Department, Cochin Hospital, Paris France</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Maillefert</surname>
<given-names>Jean Francis</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A3">Department of Rheumatology, Dijon University Hospital, Dijon, F-21078, France, University of Burgundy, Dijon, F-21079, France, INSERM U887, Dijon, F-21079, France</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Combescure</surname>
<given-names>Christophe</given-names>
</name>
<degrees>MSc, PhD</degrees>
<aff id="A4">University of Geneva, Switzerland</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Conaghan</surname>
<given-names>Philip G</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A5">Section of Musculoskeletal Disease, University of Leeds & NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, United Kingdom</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Davis</surname>
<given-names>Aileen M.</given-names>
</name>
<degrees>PhD</degrees>
<aff id="A6">Division of Health Care and Outcomes Research and Arthritis and Community Research and Evaluation Unit, Toronto Western Research Institute, Toronto, Ontario and Departments of Rehabilitation Science and Health Policy, Management and Evaluation, University of Toronto</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Gunther</surname>
<given-names>Klaus-Peter</given-names>
</name>
<degrees>MD</degrees>
<aff id="A7">Department of Orthopaedic Surgery, University of Dresden, Germany</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hawker</surname>
<given-names>Gillian</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A8">Division of Rheumatology, Department of Medicine, Women's College Hospital; Clinical Epidemiology and Health Care Research Program, Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hochberg</surname>
<given-names>Marc</given-names>
</name>
<degrees>MD, MPH</degrees>
<aff id="A9">Division of Rheumatology & Clinical Immunology, Department of Medicine and Division of Gerontology, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Katz</surname>
<given-names>Jeffrey N</given-names>
</name>
<degrees>MD, MSc</degrees>
<aff id="A10">Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School; and Department of Epidemiology, Harvard School of Public Health, Boston, MA USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Kloppenburg</surname>
<given-names>Margreet</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A11">Department of Rheumatology, Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lim</surname>
<given-names>Keith</given-names>
</name>
<degrees>MD, FRACP</degrees>
<aff id="A12">Department of Rheumatology, St Vincent's Hospital & Western Hospital, Melbourne, Australia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lohmander</surname>
<given-names>L. Stefan</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A13">Department of Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Mahomed</surname>
<given-names>Nizar N.</given-names>
</name>
<degrees>MD, ScD, FRCSC</degrees>
<aff id="A14">Division of Orthopaedic Surgery, University of Toronto, Toronto Western Hospital, Toronto, Canada</aff>
</contrib>
<contrib contrib-type="author"><name><surname>March</surname>
<given-names>Lyn</given-names>
</name>
<degrees>MD, MSc, PhD, FRACP, FAFPHM</degrees>
<aff id="A15">Institute of Bone and Joint Research, University of Sydney, Royal North Shore Hospital, St Leonards, Australia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Pavelka</surname>
<given-names>Karel</given-names>
</name>
<degrees>MD, Ph.D</degrees>
<aff id="A16">Institute of Rheumatology, Charles University Prague, Czech Republic</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Punzi</surname>
<given-names>Leonardo</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A17">Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Italy</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Roos</surname>
<given-names>Ewa M.</given-names>
</name>
<degrees>PT, PhD</degrees>
<aff id="A18">Institute of Sports and Clinical Biomechanics, University of Southern Denmark, Denmark</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Sanchez-Riera</surname>
<given-names>Lydia</given-names>
</name>
<degrees>MD</degrees>
<aff id="A19">Institute of Bone and Joint Research, University of Sydney, Australia</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Singh</surname>
<given-names>Jasvinder A.</given-names>
</name>
<degrees>MD, MPH</degrees>
<aff id="A20">Birmingham VA Medical Center and University of Alabama, Birmingham, AL, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Suarez-Almazor</surname>
<given-names>Maria E.</given-names>
</name>
<degrees>MD, PhD</degrees>
<aff id="A21">Section of Rheumatology, University of Texas, M.D. Anderson Cancer Center, Houston, Texas USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Dougados</surname>
<given-names>Maxime</given-names>
</name>
<degrees>MD</degrees>
<aff id="A22">Paris Descartes University, Medicine Faculty; APHP, Rheumatology B Department, Cochin Hospital, Paris France</aff>
</contrib>
<on-behalf-of>For the OARSI-OMERACT task force “total articular replacement as outcome measure in OA”</on-behalf-of>
</contrib-group>
<author-notes><corresp id="FN1">Correspondence: Dr. Laure Gossec, Service de Rhumatologie B, Hôpital Cochin, 27, rue du faubourg, Saint-Jacques, 75014 PARIS. Telephone: 33-158412606, Fax: 33-143549256, <email>laure.gossec@cch.aphp.fr</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>23</day>
<month>7</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>31</day>
<month>10</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="ppub"><month>2</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>02</day>
<month>9</month>
<year>2014</year>
</pub-date>
<volume>19</volume>
<issue>2</issue>
<fpage>147</fpage>
<lpage>154</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.joca.2010.10.025</pmc-comment>
<permissions><copyright-statement>© 2010 OsteoArthritis Society International. Published by Elsevier Ltd. All rights reserved.</copyright-statement>
<copyright-year>2010</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2"><italic>Design</italic>
: international cross-sectional study in 10 countries. <italic>Patients:</italic>
consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. <italic>Gold standard measure for recommendation for TJR</italic>
: surgeon's decision that TJR is justified. <italic>Outcome measures:</italic>
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). <italic>Analyses</italic>
: Comparison of patients with versus without surgeons' indication for TJR. ROC curve analyses and logistic regression were applied to determine cut-points of pain and disability defining recommendation for TJR.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 (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 versus 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’.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">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.</p>
</sec>
</abstract>
<kwd-group><kwd>Knee</kwd>
<kwd>hip</kwd>
<kwd>osteoarthritis</kwd>
<kwd>joint replacement</kwd>
<kwd>surgery</kwd>
<kwd>symptom</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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