Premium
Prospective analysis of rural–urban differences in demographic patterns and outcomes following total joint replacement
Author(s) -
Dowsey Michelle M.,
Petterwood Joshua,
Lisik James P.,
Gunn Jane,
Choong Peter F.M.
Publication year - 2014
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12100
Subject(s) - medicine , prospective cohort study , joint replacement , referral , cohort , knee replacement , knee arthritis , surgery , physical therapy , arthroplasty , osteoarthritis , family medicine , alternative medicine , pathology
Objective Little is known about whether rural–urban differences exist in patients after hip and knee joint replacement surgery. We compared patient characteristics, pain and functional outcomes of rural and urban patients undergoing joint replacement surgery in a single high‐volume metropolitan centre. Design Prospective cohort study conducted in patients who underwent primary elective hip ( THJR ) or knee replacement ( TKJR ) between 1 J anuary 2006 and 31 D ecember 2009. Setting A university‐affiliated tertiary referral centre situated in the central metropolitan region of M elbourne, A ustralia. Participants One thousand nine hundred fifty‐five consecutive patients undergoing primary total joint replacement.Main outcome measure Pain and function were assessed preoperatively and 12 and 24 months postoperatively. The main independent variable was geographic location specifically comparing patients residing in rural/regional compared with urban communities. Results A total of 2193 primary joint replacements were performed (981 THJR and 1212 TKJR ) in 1955 patients. Rural patients presented at a younger age and with earlier radiographic disease than their urban counterparts. There was a higher rate of rheumatoid arthritis among rural patients presenting for TKJR . There was no difference in pain and function scores between groups at 12 and 24 months post‐surgery. Conclusion In our series of 1955 patients undergoing total hip and knee joint replacement surgery, rural patients presented at a younger age and an earlier stage of disease progression. At 24 months, rural patients had pain and functional outcomes as good as their urban counterparts. More research is required to determine which factors lead to the early presentation of rural patients.