ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2137

Important Predictors Of Patient-Reported Outcomes After TKR and THR Are Not Included In Risk Models Based On Administrative Data

Patricia D. Franklin1, Leslie R. Harrold2, Wenjun Li1, Jeroan Allison3, David Ayers1 and Courtland Lewis4, 1Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, MA, 2University of Massachusetts Medical School, Worcester, MA, 3Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 4Hartford Hospital, Hartford, CT

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Comorbidity, Osteoarthritis, outcome measures and total joint replacement

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Title: Osteoarthritis - Clinical Aspects II: Symptoms and Therapeutics in Osteoarthritis.

Session Type: Abstract Submissions (ACR)

Background/Purpose: Because total knee (TKR) and total hip (THR) replacement surgery is performed to relieve pain and improve physical function in patients with advanced arthritis, there is growing demand to use patient-reported outcomes (PROs) to assess TKR effectiveness. The UK and others now require PRO assessment after TKR. Thus, a clear understanding of pre-existing clinical factors that influence PROs after surgery is needed before comparing PROs across providers. We evaluated the roles of medical  and musculoskeletal comorbidities in explaining variation in 6 month post-TKR and THR pain relief and functional gain.

Methods: A US cohort of 1,578 TKR and 1,166 THR patients  reported sociodemographic (age, sex, race), BMI, modified Charlson comorbidity, arthritic disease severity (Hip Disability/Knee Injury and Osteoarthritis Outcome Scores (HOOS/KOOS)) in both knees and hips, lumbar disease using the Oswestry Disabiity Index (ODI), emotional health based on the Short Form 36 (SF-36) Mental Component Score (MCS), and physical function (SF-36 PCS). Predictors of change in pre-to-6 month post-TKR and post-THR pain and function were examined using linear mixed models adjusting for clustering within site. 

Results: TKR patients had a mean age of 66 years, mean BMI of 31.5, and were 62% female and 6.8% black. Nine percent (9%) reported Charlson of 2-5, 15% with Charlson of 6, 7% moderate/severe pain in 2-3 knee/hip joints, and 26% moderate/severe lumbar pain. After adjusting for sociodemographic factors, significant predictors of poorer 6 month post-THR pain included poorer emotional health, higher Charlson comorbidities and any lumbar pain at time of THR. These factors also predicted poorer 6 month function.

THR patients had a mean age of 64 years, mean BMI of 29.2, and were 61% female and 4% black. Six percent (6%) reported Charlson of 2-5, 15% with Charlson of 6, 9% moderate/severe pain in 2-3 knee/hip joints, and 34% moderate/severe lumbar pain. After adjusting for sociodemographic factors, significant predictors of poorer 6 month post-THR pain included poorer emotional health, Charlson of 1, and severe lumbar pain at time of THR. These factors also predicted poorer 6 month function, as well as greater BMI and moderate/severe pain in non-operative knees/hips.

Conclusion: Before adopting PROs as a standard measure of TKR or THR effectiveness, a complete understanding of pre-existing clinical factors associated with poorer pain relief and functional gain is needed. These analyses suggest that greater musculoskeletal, as well as medical, comorbid conditions are associated post-operative patient-reported outcomes and should be included in risk-adjustment models.


Disclosure:

P. D. Franklin,

NIAMS-NIH, NLM-NIH, AHRQ, Zimmer, ,

2;

L. R. Harrold,

CORRONA, Inc.,

5;

W. Li,

AHRQ,

2;

J. Allison,

AHRQ,

2;

D. Ayers,

AHRQ, Zimmer,

2;

C. Lewis,
None.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/important-predictors-of-patient-reported-outcomes-after-tkr-and-thr-are-not-included-in-risk-models-based-on-administrative-data/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology