ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1654

The Relationship Between Patient-Reported Readiness for Total Knee Arthroplasty and the Likelihood of a Good Outcome at One Year

Gillian Hawker1, Barbara Conner-Spady2, Eric Bohm3, Michael Dunbar4, Allyson Jones5, Bheeshma Ravi1, Tom Noseworthy2, Linda Woodhouse6, Peter Faris7, Donald Dick8, James Powell2, Paulose Paul5 and Deborah Marshall2, 1University of Toronto, Toronto, ON, Canada, 2University of Calgary, Calgary, AB, Canada, 3Concordia Hip & Knee Institute, University of Manitoba, Winnipeg, MB, Canada, 4Dalhousie University, Halifax, NS, Canada, 5University of Alberta, Edmonton, AB, Canada, 6Curtin University, Perth, Western Australia, Australia, 7Alberta Health Services, Calgary, ON, Canada, 8Alberta Bone and Joint Health Institute, Edmonton, AB, Canada

Meeting: ACR Convergence 2020

Keywords: , ,

Session Information

Date: Monday, November 9, 2020

Session Title: Osteoarthritis – Clinical Poster II

Session Type: Poster Session D

Session Time: 9:00AM-11:00AM

Background/Purpose: In prior qualitative research, we found that patients with knee osteoarthritis (OA) equated appropriateness for total knee arthroplasty (TKA) with candidacy for the procedure. Pain intensity, the ability to cope with the pain and how the pain affected quality of life were seen as important factors determining surgical candidacy. The importance of psychological readiness and a positive attitude, were additionally perceived as critical to achievement of a good TKA outcome. The current study examined the relationship between patients’ pre-operative psychological readiness for TKA and surgical outcome at one year.

Methods: This prospective cohort study recruited knee OA patients aged 30+ years referred for TKA at two hip/knee surgery centers in Alberta, Canada. All participants met ACR criteria for knee OA. Those who received primary, unilateral TKA completed questionnaires pre-TKA to assess TKA readiness (Patient Acceptable Symptom State – knee symptoms acceptable/unacceptable; Perceived Arthritis Coping Efficacy; General Self-Efficacy; definite willingness to undergo TKA – yes/no) and covariates (age, sex, WOMAC pain, Knee injury and Osteoarthritis Outcome Score Physical Function [KOOS-PS], Patient Health Questionnaire depression scale, BMI, comorbidities), and one year post-TKA to assess TKA outcome. A good TKA outcome was defined as improved knee symptoms (OARSI-OMERACT responder criteria) AND overall satisfaction with TKA results (yes/no). Using multivariable logistic regression, we examined the relationship of our exposures to a good TKA outcome, before and after controlling for covariates.

Results: Of 1,272 TKA recipients assessed at one year, 1,030 without complications and with data for the primary outcome were included (mean age 66.9 years [SD 8.8]; 58.5% female). 79.3% achieved a good TKA outcome. In multivariable analysis, controlling for covariates, unacceptable knee symptoms and definite willingness to undergo TKA were associated with higher odds of a good TKA outcome (adjusted ORs 1.55, 95% CI, 1.06 – 2.71, and 1.70, 95% CI 1.09 – 2.66, respectively).

Conclusion: Among OA TKA recipients, greater psychological readiness for TKA was associated with higher odds of a good TKA outcome. Incorporation of patient readiness in TKA decision-making may enhance patient outcomes and appropriate use of TKA.

Disclosure: G. Hawker, University of Toronto, 2; B. Conner-Spady, None; E. Bohm, None; M. Dunbar, None; A. Jones, None; B. Ravi, None; T. Noseworthy, None; L. Woodhouse, None; P. Faris, None; D. Dick, None; J. Powell, None; P. Paul, None; D. Marshall, University of Calgary, 2.

To cite this abstract in AMA style:

Hawker G, Conner-Spady B, Bohm E, Dunbar M, Jones A, Ravi B, Noseworthy T, Woodhouse L, Faris P, Dick D, Powell J, Paul P, Marshall D. The Relationship Between Patient-Reported Readiness for Total Knee Arthroplasty and the Likelihood of a Good Outcome at One Year [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/the-relationship-between-patient-reported-readiness-for-total-knee-arthroplasty-and-the-likelihood-of-a-good-outcome-at-one-year/. Accessed March 1, 2021.

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