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Better Functional and Similar Pain Outcomes in Osteoarthritis Compared to Rheumatoid Arthritis After Primary Total Knee Arthroplasty: A Cohort Study
Author(s) -
Singh Jasvinder A.,
Lewallen David G.
Publication year - 2013
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22090
Subject(s) - medicine , osteoarthritis , odds ratio , rheumatoid arthritis , confidence interval , arthroplasty , logistic regression , physical therapy , arthritis , activities of daily living , cohort , total knee arthroplasty , surgery , alternative medicine , pathology
Objective To determine the association of the underlying diagnosis with limitation in activities of daily living (ADL) and pain in patients undergoing primary total knee arthroplasty (TKA). Methods Prospectively collected data from the Mayo Clinic Total Joint Registry were used to assess the association of diagnosis with moderate–severe limitation in ADL and moderate–severe pain at 2 and 5 years after primary TKA, using multivariable‐adjusted logistic regression analyses. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs). Results There were 7,139 primary TKAs at 2 years and 4,234 at 5 years. In multivariable‐adjusted analyses, compared with rheumatoid arthritis (RA)/inflammatory arthritis, osteoarthritis (OA) was associated with significantly lower moderate–severe ADL limitation at 2 years (OR 0.5 [95% CI 0.3–0.8]) ( P = 0.004) and at 5 years (OR 0.5 [95% CI 0.3–0.9]) ( P = 0.02). There was no significant association of diagnosis of OA with moderate–severe pain at 2 years (OR 1.2 [95% CI 0.5–2.7]) ( P = 0.68) or at 5 years (OR 1.0 [95% CI 0.3–3.7]) ( P = 1.0). Conclusion We found that patients with OA who underwent primary TKA had better ADL outcomes compared to patients with RA/inflammatory arthritis at 2 and 5 years. On the other hand, the pain outcomes after primary TKA did not differ in OA versus RA. This suggests a discordant effect of underlying diagnosis on pain and function outcomes after TKA. These novel findings can be used to better inform both patients and surgeons about expected pain and function outcomes after primary TKA.