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Research

DIFFERENCES IN PRE-OP CHARACTERISTICS BETWEEN TKR AND THR PATIENTS: RESULTS FROM FORCE-TJR A NATIONAL US COHORT

8th Combined Meeting Of Orthopaedic Research Societies (CORS)



Abstract

Summary Statement

This data may help explain the variability in physical function after primary TKR as compared to primary THR.

Introduction

Total knee replacement (TKR) and total hip replacement (THR) reliably relieve pain, restore function, and ensure mobility in patients with advanced joint arthritis; however these results are not uniform across all patient populations. We compared baseline demographic and symptom profiles in patients from a US national cohort undergoing primary TKR and THR.

Methods

Patients undergoing primary TKR and THR between 7/1/2011 and 3/30/2012 were identified from the national research consortium which collects comprehensive data on enrolled patients from 120 surgeons across 23 states. Gathered data includes patient demographics, comorbidity (Charlson Comorbidity Index), operative joint pain severity, physical function (SF-36; Physical Component Score (PCS)), emotional health (SF-36 Mental Component Score (MCS)), and musculoskeletal burden of illness (Hip and Knee Disability and Osteoarthritis Outcome Scores; Oswestry Disability Index). Descriptive statistics compared baseline demographic and symptom profiles.

Results

Our analysis compared 1362 primary TKR patients and 1013 primary THR patients. US TKR patients were significantly older (66.5 vs. 64.3 years), more obese (BMI 31.7 vs. 29.3), and less educated (p<0.005). TKR patients had higher rates of comorbidities, specifically diabetes, gastrointestinal ulcers, and cerebrovascular disease (p≤0.006). THR patients had significantly worse physical function (PCS 31.6 vs. 33.3), lower back pain (35.6% vs. 30.5% moderate-severe), and operative joint pain, stiffness, and function (p<0.005).

Conclusion

US patients undergoing primary TKR are older with more comorbidities, however THR patient baseline functional and musculoskeletal limitations are significantly greater than primary TKR patients.