First knee for pain and function versus second knee for quality of life-Reference-Cited by-同舟云学术

First knee for pain and function versus second knee for quality of life

Published:2024-03-11 Issue:3 Volume:5 Page:202-209
ISSN:2633-1462
Container-title:Bone & Joint Open
language:en
Short-container-title:Bone Jt Open

Author:

Lewin Adriane M.¹²^ORCID,Cashman Kara³^ORCID,Harries Dylan³^ORCID,Ackerman Ilana N.⁴^ORCID,Naylor Justine M.¹²⁵^ORCID,Harris Ian A.¹²⁵⁶^ORCID

Affiliation:

1. South West Clinical Campuses, School of Clinical Medicine, UNSW Medicine & Health, Liverpool, Australia

2. Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, Australia

3. South Australian Health and Medical Research Institute, Adelaide, Australia

4. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

5. South West Sydney Local Health District, NSW Health, Sydney, Australia

6. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, Australia

Abstract

AimsThe aim of this study was to describe and compare joint-specific and generic health-related quality of life outcomes of the first versus second knee in patients undergoing staged bilateral total knee arthroplasty (BTKA) for osteoarthritis.MethodsThis retrospective cohort study used Australian national arthroplasty registry data from January 2013 to January 2021 to identify participants who underwent elective staged BTKA with six to 24 months between procedures. The primary outcome was Oxford Knee Score (OKS) at six months postoperatively for the first TKA compared to the second TKA, adjusted for age and sex. Secondary outcomes compared six-month EuroQol five-dimension five-level (EQ-5D-5L) domain scores, EQ-5D index scores, and the EQ visual analogue scale (EQ-VAS) between knees at six months postoperatively.ResultsThe cohort included 635 participants (1,270 primary procedures). Preoperative scores were worse in the first knee compared to the second for all instruments; however, comparing the first knee at six months postoperatively with the second knee at six months postoperatively, the mean between-knee difference was minimal for OKS (-0.8 points; 95% confidence interval (CI) -1.4 to -0.2), EQ-VAS (3.3; 95% CI 1.9 to 4.7), and EQ-5D index (0.09 points; 95% CI 0.07 to 0.12). Outcomes for the EQ-5D-5L domains ‘mobility’, ‘usual activities’, and ‘pain/discomfort’ were better following the second TKA.ConclusionAt six months postoperatively, there were no clinically meaningful differences between the first and second TKA in either the joint-specific or overall generic health-related quality of life outcomes. However, individual domain scores assessing mobility, pain, and usual activities were notably higher after the second TKA, likely reflecting the cumulative improvement in quality of life after both knees have been replaced.Cite this article: Bone Jt Open 2024;5(3):202–209.

Publisher

British Editorial Society of Bone & Joint Surgery

Link

https://boneandjoint.org.uk/doi/10.1302/2633-1462.53.BJO-2023-0035.R1/pdf

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