PURPOSE: To identify the characteristics of people with hip or knee osteoarthritis (OA) attending a regional triage centre for an initial consult who are deemed not yet ready for total joint arthroplasty (TJA). METHODS: Initial consultation notes (n=482) were reviewed retrospectively. Predictive variables were derived from the literature a priori, and 14 of these variables were suitable for inclusion in stepwise multiple logistic regression analyses. RESULTS: Of the 222 eligible people, 131 (59%) were deemed not yet ready for TJA. Five variables entered into the model ([Formula: see text]=133.19, p<0.001) for an overall success rate of 81.1%. Those deemed not yet ready for TJA were more likely to have knee OA (vs. hip OA; odds ratio [OR]=0.352, p=0.018), to have less severe OA (OR=0.246 for each category increase in severity, p<0.001), to use no gait aid (vs. cane; OR=0.390, p=0.033), and to have a higher Lower Extremity Functional Scale score (OR=1.050 for each 1-point increase, p=0.003) and better joint status as measured by the Knee Society Scale or Hip Harris Scale (OR=3.946 for each category increase, p=0.007). CONCLUSION: Considering these characteristics will help clinicians to identify individuals likely to require interventions other than TJA.
PURPOSE: To identify the characteristics of people with hip or knee osteoarthritis (OA) attending a regional triage centre for an initial consult who are deemed not yet ready for total joint arthroplasty (TJA). METHODS: Initial consultation notes (n=482) were reviewed retrospectively. Predictive variables were derived from the literature a priori, and 14 of these variables were suitable for inclusion in stepwise multiple logistic regression analyses. RESULTS: Of the 222 eligible people, 131 (59%) were deemed not yet ready for TJA. Five variables entered into the model ([Formula: see text]=133.19, p<0.001) for an overall success rate of 81.1%. Those deemed not yet ready for TJA were more likely to have knee OA (vs. hip OA; odds ratio [OR]=0.352, p=0.018), to have less severe OA (OR=0.246 for each category increase in severity, p<0.001), to use no gait aid (vs. cane; OR=0.390, p=0.033), and to have a higher Lower Extremity Functional Scale score (OR=1.050 for each 1-point increase, p=0.003) and better joint status as measured by the Knee Society Scale or Hip Harris Scale (OR=3.946 for each category increase, p=0.007). CONCLUSION: Considering these characteristics will help clinicians to identify individuals likely to require interventions other than TJA.
Entities:
Keywords:
health services; hip; knee; mobility limitation; osteoarthritis
Authors: Fraser Birrell; Cara Afzal; Elizabeth Nahit; Mark Lunt; Gary J Macfarlane; Cyrus Cooper; Peter R Croft; Gillian Hosie; Alan J Silman Journal: Br J Gen Pract Date: 2003-01 Impact factor: 5.386