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
Identifieur interne : 006E67 ( Main/Exploration ); précédent : 006E66; suivant : 006E68The 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
Auteurs : Laure Gossec ; Simon Paternotte ; Jean Francis Maillefert ; Christophe Combescure ; Philip G. Conaghan ; Aileen M. Davis ; Klaus-Peter Gunther ; Gillian Hawker ; Marc Hochberg ; Jeffrey N. Katz ; Margreet Kloppenburg ; Keith Lim ; L. Stefan Lohmander ; Nizar N. Mahomed ; Lyn March ; Karel Pavelka ; Leonardo Punzi ; Ewa M. Roos ; Lydia Sanchez-Riera ; Jasvinder A. Singh ; Maria E. Suarez-Almazor ; Maxime DougadosSource :
- Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society [ 1063-4584 ] ; 2010.
Abstract
To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA).
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’.
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.
Url:
DOI: 10.1016/j.joca.2010.10.025
PubMed: 21044689
PubMed Central: 4151518
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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><affiliations><list></list><tree><noCountry><name sortKey="Combescure, Christophe" sort="Combescure, Christophe" uniqKey="Combescure C" first="Christophe" last="Combescure">Christophe Combescure</name><name sortKey="Conaghan, Philip G" sort="Conaghan, Philip G" uniqKey="Conaghan P" first="Philip G" last="Conaghan">Philip G. Conaghan</name><name sortKey="Davis, Aileen M" sort="Davis, Aileen M" uniqKey="Davis A" first="Aileen M." last="Davis">Aileen M. Davis</name><name sortKey="Dougados, Maxime" sort="Dougados, Maxime" uniqKey="Dougados M" first="Maxime" last="Dougados">Maxime Dougados</name><name sortKey="Gossec, Laure" sort="Gossec, Laure" uniqKey="Gossec L" first="Laure" last="Gossec">Laure Gossec</name><name sortKey="Gunther, Klaus Peter" sort="Gunther, Klaus Peter" uniqKey="Gunther K" first="Klaus-Peter" last="Gunther">Klaus-Peter Gunther</name><name sortKey="Hawker, Gillian" sort="Hawker, Gillian" uniqKey="Hawker G" first="Gillian" last="Hawker">Gillian Hawker</name><name sortKey="Hochberg, Marc" sort="Hochberg, Marc" uniqKey="Hochberg M" first="Marc" last="Hochberg">Marc Hochberg</name><name sortKey="Katz, Jeffrey N" sort="Katz, Jeffrey N" uniqKey="Katz J" first="Jeffrey N" last="Katz">Jeffrey N. Katz</name><name sortKey="Kloppenburg, Margreet" sort="Kloppenburg, Margreet" uniqKey="Kloppenburg M" first="Margreet" last="Kloppenburg">Margreet Kloppenburg</name><name sortKey="Lim, Keith" sort="Lim, Keith" uniqKey="Lim K" first="Keith" last="Lim">Keith Lim</name><name sortKey="Lohmander, L Stefan" sort="Lohmander, L Stefan" uniqKey="Lohmander L" first="L. Stefan" last="Lohmander">L. Stefan Lohmander</name><name sortKey="Mahomed, Nizar N" sort="Mahomed, Nizar N" uniqKey="Mahomed N" first="Nizar N." last="Mahomed">Nizar N. Mahomed</name><name sortKey="Maillefert, Jean Francis" sort="Maillefert, Jean Francis" uniqKey="Maillefert J" first="Jean Francis" last="Maillefert">Jean Francis Maillefert</name><name sortKey="March, Lyn" sort="March, Lyn" uniqKey="March L" first="Lyn" last="March">Lyn March</name><name sortKey="Paternotte, Simon" sort="Paternotte, Simon" uniqKey="Paternotte S" first="Simon" last="Paternotte">Simon Paternotte</name><name sortKey="Pavelka, Karel" sort="Pavelka, Karel" uniqKey="Pavelka K" first="Karel" last="Pavelka">Karel Pavelka</name><name sortKey="Punzi, Leonardo" sort="Punzi, Leonardo" uniqKey="Punzi L" first="Leonardo" last="Punzi">Leonardo Punzi</name><name sortKey="Roos, Ewa M" sort="Roos, Ewa M" uniqKey="Roos E" first="Ewa M." last="Roos">Ewa M. Roos</name><name sortKey="Sanchez Riera, Lydia" sort="Sanchez Riera, Lydia" uniqKey="Sanchez Riera L" first="Lydia" last="Sanchez-Riera">Lydia Sanchez-Riera</name><name sortKey="Singh, Jasvinder A" sort="Singh, Jasvinder A" uniqKey="Singh J" first="Jasvinder A." last="Singh">Jasvinder A. Singh</name><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></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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