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Abstract Number: 1086

Has the Level of Disability At Time of TKR Changed Over the Past 10 Years?: Results From Two National Cohorts

Patricia D. Franklin1, Wenjun Li1, Benjamin Snyder2, Courtland Lewis3, Philip Noble4 and David Ayers1, 1Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, MA, 2Orthopedics, University of Massachusetts Medical School, Worcester, MA, 3CT Joint Replacement Institute, St. Francis Hospital, Hartford, CT, 4Baylor College of Medicine, Houston, TX

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Orthopedics, outcome measures and total joint replacement

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Session Information

Session Title: Orthopedics, Low Back Pain, and Rehabilitation

Session Type: Abstract Submissions (ACR)

Background/Purpose: A growing numbers of younger adults report knee pain consistent with OA, although parallel analyses of knee x-rays show no increase in classic radiographic signs of OA. To evaluate whether surgeons are performing TKR at an earlier stage in the condition, we compared pre-operative demographic and symptom profiles from 2 national cohorts of TKR patients, one from 2011-2012 and another from 2000-2004.

Methods: Following informed consent, we collected comprehensive demographic, comorbidity, and patient-reported pain and physical function from a national sample of 2011-12 TKR patients, across 27 states with 89 surgeons. Comparable data collected by one implant manufacturer between 2000-2004 from 136 surgeons in 31 states were analyzed. Descriptive statistics compared the demographic and symptom profiles of the two cohorts.

Results: There were minimal differences between the two cohorts in terms of age (2011-12: 66.5 years, vs. 2000/4: 67.6 years; p0.05). The more recent patient cohort consisted of fewer females (57%) compared to the earlier group (66%). Pre-operative physical function scores (SF36/PCS) were 3 points higher in 2011-12 than 2000-04 (33.6±0.3 vs. 30.3±0.1; p<0.0000). The 2000-2004 cohort (n=7686) had a mean BMI of 32 vs 31.7 for the 2011-12 cohort (n=1362). When compared to the national PCS norm of 50 (SD=10), TKR patients from both time periods reported pre-operative function levels almost 2 standard deviations below the national norm.

Conclusion: The profile of primary TKR patients changed between 2000-04, and 2011-12. Today, patients are younger and have a higher pre-operative physical function scores. They continue to report significant levels of disability with mean pre-TKR PCS significantly lower than average OA patients.


Disclosure:

P. D. Franklin,

Zimmer, Inc.,

2;

W. Li,
None;

B. Snyder,
None;

C. Lewis,
None;

P. Noble,

Zimmer;,Stryker,Omni,SN,

7;

D. Ayers,
None.

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