In the Journals

Pain and functional outcomes worsen over time after TKA, study finds

During a study period spanning 1993 to 2005, researchers observed a worsening of patient-reported function and pain outcomes after total knee arthroplasty.

The researchers reviewed data for 7,229 patients from the Mayo Clinic Total Joint Registry who underwent total knee arthroplasty (TKA) between 1993 and 2005. Patients’ mean age was 68.4 years, and mean BMI was 31.1. Those selected for inclusion in the final study had completed a preoperative and/or postoperative pain and function questionnaire.

When appropriate, the researchers used chi-square test and analysis for variance and performed multivariable-adjusted analyses using logistic regression. Because the main study objective was to determine whether changes in pain and activity limitation occurred over time, the study period was divided into the time periods 1993 to 1995, 1996 to 1998, 1999 to 2001 and 2002 to 2005.

Patient-reported outcomes, moderate-to-severe limitation of activities of daily living and moderate-to-severe pain were the outcomes of interest. Patients were categorized into different levels of limitation based on their responses when walking, climbing stairs and getting out of a chair.

Preoperatively, moderate-to-severe overall limitation and moderate-to-severe pain were seen in 7.3% fewer patients and 2.7% more patients, respectively, in the 2000 to 2005 period compared with the 1993 to 1995 period. At the 2-year postoperative assessment, the researchers found moderate-to-severe overall limitation was reported in 4.7% more patients, and 3.6% more patients reported moderate-to-severe post-TKA pain in the 2002 to 2005 period compared with the 1993 to 1995 period. Both findings were considered statistically significant, according to the researchers.

Upon adjusting for age, sex, anxiety, depression, Deyo-Charlson index, BMI and preoperative pain and limitation, analyses showed patients had worse outcomes 2 years after undergoing TKA in 2002 to 2005 compared with those who underwent TKA in 1993 to 1995, with odds ratios of 1.34 and 1.79 for moderate-to-severe activity limitation and moderate-to-severe pain, respectively. – by Monica Jaramillo

Disclosure: The authors report no financial conflicts related directly to this study. Singh has received research and travel grants from Takeda and Savient and consultant fees from Savient, Takeda, Regeneron and Allergan, and Novartis. Please see the full study for a list of all other authors’ relevant financial disclosures.

During a study period spanning 1993 to 2005, researchers observed a worsening of patient-reported function and pain outcomes after total knee arthroplasty.

The researchers reviewed data for 7,229 patients from the Mayo Clinic Total Joint Registry who underwent total knee arthroplasty (TKA) between 1993 and 2005. Patients’ mean age was 68.4 years, and mean BMI was 31.1. Those selected for inclusion in the final study had completed a preoperative and/or postoperative pain and function questionnaire.

When appropriate, the researchers used chi-square test and analysis for variance and performed multivariable-adjusted analyses using logistic regression. Because the main study objective was to determine whether changes in pain and activity limitation occurred over time, the study period was divided into the time periods 1993 to 1995, 1996 to 1998, 1999 to 2001 and 2002 to 2005.

Patient-reported outcomes, moderate-to-severe limitation of activities of daily living and moderate-to-severe pain were the outcomes of interest. Patients were categorized into different levels of limitation based on their responses when walking, climbing stairs and getting out of a chair.

Preoperatively, moderate-to-severe overall limitation and moderate-to-severe pain were seen in 7.3% fewer patients and 2.7% more patients, respectively, in the 2000 to 2005 period compared with the 1993 to 1995 period. At the 2-year postoperative assessment, the researchers found moderate-to-severe overall limitation was reported in 4.7% more patients, and 3.6% more patients reported moderate-to-severe post-TKA pain in the 2002 to 2005 period compared with the 1993 to 1995 period. Both findings were considered statistically significant, according to the researchers.

Upon adjusting for age, sex, anxiety, depression, Deyo-Charlson index, BMI and preoperative pain and limitation, analyses showed patients had worse outcomes 2 years after undergoing TKA in 2002 to 2005 compared with those who underwent TKA in 1993 to 1995, with odds ratios of 1.34 and 1.79 for moderate-to-severe activity limitation and moderate-to-severe pain, respectively. – by Monica Jaramillo

Disclosure: The authors report no financial conflicts related directly to this study. Singh has received research and travel grants from Takeda and Savient and consultant fees from Savient, Takeda, Regeneron and Allergan, and Novartis. Please see the full study for a list of all other authors’ relevant financial disclosures.