Differences in Baseline Characteristics Between TKR and THR Patients: Results From a National Research Consortium

Patricia D. Franklin¹, Benjamin Snyder², Jeroan Allison³, Wenjun Li¹, Milagros Rosal⁴, Leslie R. Harrold⁵, Bruce Barton³ and David Ayers¹, ¹Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, MA, ²Orthopedics, University of Massachusetts Medical School, Worcester, MA, ³Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, ⁴Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, ⁵Dept of Medicine, UMass Medical School, Worcester, MA

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Orthopedics, outcome measures and total joint replacement

Session Information

Title: Orthopedics, Low Back Pain, and Rehabilitation

Session Type: Abstract Submissions (ACR)

Background/Purpose: Both total knee replacement (TKR) and total hip replacement (THR) reliably relieve pain, restore function, and ensure mobility in patients with advanced joint arthritis; however these results are not uniform across all patient populations. Previous studies have shown baseline differences between patients undergoing TKR and THR. We compared baseline demographic and symptom profiles in a national research consortium of advanced OA patients undergoing primary TKR and THR to evaluate these differences.

Methods: Patients undergoing primary TKR and THR between 7/1/2011 and 3/30/2012 were identified from the national research consortium which collects comprehensive data on enrolled patients from 89 surgeons across 27 states. Gathered data includes patient demographics, comorbidity (Charlson Comorbidity Index), operative joint pain severity, physical function (SF-36; Physical Component Score (PCS)), emotional health (SF-36 Mental Component Score (MCS)), and musculoskeletal burden of illness ( Hip and Knee Disability and Osteoarthritis Outcome Scores;Oswestry Disability Index. Descriptive statistics compared baseline demographic and symptom profiles.

Results: Our analysis compared 1362 primary TKR patients and 1013 primary THR patients. TKR patients were significantly older (66.5 vs. 64.3 years), more obese (BMI 31.7 vs. 29.3), and less educated (p<0.005). TKR patients had higher rates of comorbidities, specifically diabetes, gastrointestinal ulcers, and cerebrovascular disease (p≤0.006). THR patients had significantly worse physical function (PCS 31.6 vs. 33.3), lower back pain (35.6% vs. 30.5% moderate-severe), and operative joint pain, stiffness, and function (p<0.005).

Conclusion: Patients undergoing primary TKR are older with more comorbidities, however THR patient baseline functional and musculoskeletal disability are significantly greater than primary TKR patients, which may help explain the variability in results shown after primary TKR as compared to primary THR.

Disclosure:

P. D. Franklin,

Zimmer, Inc.,

B. Snyder,
None;

J. Allison,
None;

W. Li,
None;

M. Rosal,
None;

L. R. Harrold,
None;

B. Barton,
None;

D. Ayers,
None.

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