Bashir Zikria1,2, Nima Hafezi-Nejad3, John Wilckens4, James R Ficke4, Shadpour Demehri3. 1. Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, USA. bzikria2@jhmi.edu. 2. Johns Hopkins Department of Orthopedics, Johns Hopkins University, 4924 Campbell Road Suite 130, Baltimore, MD, 21236, USA. bzikria2@jhmi.edu. 3. Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD, USA. 4. Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Abstract
OBJECTIVE: To investigate the risk and determinants of knee replacement (KR) in subjects with or at risk of osteoarthritis (OA) and a history of arthroscopy. METHODS: Data from the osteoarthritis initiative cohort were analyzed (n = 4796, up to the seventh year of follow-up). Cox proportional hazard analysis was used to determine the risk of KR according to the history of arthroscopy. A multivariable model was used to determine the risk factors for KR among subjects with a history of arthroscopy (n = 842), including age, gender, body mass index, history of knee injury, and baseline physical activity scale for the elderly, Western Ontario and McMaster (WOMAC) total score, and radiographic Kellgren and Lawrence (KL) score. RESULTS: History of arthroscopy was associated with risk of KR after adjustments for the mentioned determinants of OA (HR: 1.90 (1.49-2.44); P value <0.001). Female gender (HR: 1.86 (1.30-2.68); P value <0.001), higher WOMAC (HR: 1.02 (1.01-1.03); P value <0.001), and KL score (HR: 2.64 (2.08-3.35); P value <0.001) increased the risk of KR among subjects with a history of arthroscopy. Subjects with a history of knee injury had 50 % lower risk of KR (HR: 0.50 (0.35-0.72); P value <0.001) after arthroscopy. CONCLUSION: Female gender, more clinical symptoms and radiographic signs of OA, was associated with higher risk of future KR in subjects with a history of arthroscopy. Subjects with arthroscopy in the setting of concomitant knee injury were 50 % less likely to undergo KR compared to subjects who underwent arthroscopy without a history of concomitant knee injury.
OBJECTIVE: To investigate the risk and determinants of knee replacement (KR) in subjects with or at risk of osteoarthritis (OA) and a history of arthroscopy. METHODS: Data from the osteoarthritis initiative cohort were analyzed (n = 4796, up to the seventh year of follow-up). Cox proportional hazard analysis was used to determine the risk of KR according to the history of arthroscopy. A multivariable model was used to determine the risk factors for KR among subjects with a history of arthroscopy (n = 842), including age, gender, body mass index, history of knee injury, and baseline physical activity scale for the elderly, Western Ontario and McMaster (WOMAC) total score, and radiographic Kellgren and Lawrence (KL) score. RESULTS: History of arthroscopy was associated with risk of KR after adjustments for the mentioned determinants of OA (HR: 1.90 (1.49-2.44); P value <0.001). Female gender (HR: 1.86 (1.30-2.68); P value <0.001), higher WOMAC (HR: 1.02 (1.01-1.03); P value <0.001), and KL score (HR: 2.64 (2.08-3.35); P value <0.001) increased the risk of KR among subjects with a history of arthroscopy. Subjects with a history of knee injury had 50 % lower risk of KR (HR: 0.50 (0.35-0.72); P value <0.001) after arthroscopy. CONCLUSION: Female gender, more clinical symptoms and radiographic signs of OA, was associated with higher risk of future KR in subjects with a history of arthroscopy. Subjects with arthroscopy in the setting of concomitant knee injury were 50 % less likely to undergo KR compared to subjects who underwent arthroscopy without a history of concomitant knee injury.
Authors: Aman Dhawan; Richard C Mather; Vasili Karas; Michael B Ellman; Benjamin B Young; Bernard R Bach; Brian J Cole Journal: Arthroscopy Date: 2013-11-28 Impact factor: 4.772
Authors: Weiya Zhang; Daniel F McWilliams; Sarah L Ingham; Sally A Doherty; Stella Muthuri; Kenneth R Muir; Michael Doherty Journal: Ann Rheum Dis Date: 2011-05-25 Impact factor: 19.103
Authors: Alexandra Kirkley; Trevor B Birmingham; Robert B Litchfield; J Robert Giffin; Kevin R Willits; Cindy J Wong; Brian G Feagan; Allan Donner; Sharon H Griffin; Linda M D'Ascanio; Janet E Pope; Peter J Fowler Journal: N Engl J Med Date: 2008-09-11 Impact factor: 91.245