Article

Impact of Race/Ethnicity in OA Treatment

Thurston Arthritis Research Center, University of North Carolina, 3300 Doc J. Thurston, Jr. Bldg. CB#7280, Chapel Hill, NC 27599-7280 USA.
HSS Journal 02/2012; 8(1):39-41. DOI: 10.1007/s11420-011-9256-6
Source: PubMed
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    ABSTRACT: Objective Unicompartmental Knee Replacement (UKR) has important advantages over total knee replacement (TKR) but has a higher revision rate. Outcomes vary between centres, suggesting that risk factors for revision may be modifiable with changes to patient selection or operative technique. The objective of this study was to determine factors affecting revision, patient-reported outcome and satisfaction following UKR. Method 25,982 cases from three national databases were analysed. Multilevel multivariable regression models were used to examine the effect of patient and surgical factors on implant survival, patient-reported outcome and satisfaction at six months and eight years following UKR. Results Of the 25,982 cases, 3,862 (14.9%) had pre-operative and six-month Oxford Knee Scores (OKS). Eight-year survival was 89.1% (95% CI 88.3-89.9). OKS increased from 21.9 (SD 7.6) to 37.5 (SD 9.5). Age (HR 0.96 (95%CI 0.96-0.97) per year), male gender (HR 0.86 (95%CI 0.76-0.96)), unit size (HR 0.92 (95%CI 0.86-0.97) per case up to 40 cases/year) and operating surgeon grade (HR 0.78 (95%CI 0.67-0.91) if consultant) predicted improved implant survival. Older patients (≤75 years), and those with lower deprivation levels had superior OKS and satisfaction (adjusted mean difference 0.14 (95%CI 0.09-0.20) points per year of age and 0.93 (95%CI 0.60-1.27) per quintile of deprivation). Ethnicity, anxiety and co-morbidities also affected patient-reported outcome. Conclusions This study has identified important predictors of revision and patient-reported outcome following UKR. Older patients, who are least likely to be offered UKR, may derive the greatest benefits. Improved understanding of these factors may improve the long-term outcomes of UKR.
    Osteoarthritis and Cartilage 09/2014; 22(9). DOI:10.1016/j.joca.2014.07.006 · 4.66 Impact Factor

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