Total knee replacement in patients with concomitant back pain results in a worse functional outcome and a lower rate of satisfaction

N. D. Clement*, D. MacDonald, A. H. R. W. Simpson, R. Burnett

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

This study assessed the effect of concomitant back pain on the Oxford knee score (OKS), Short-Form (SF)-12 and patient satisfaction after total knee replacement (TKR). It involved a prospectively compiled database of demographics and outcome scores for 2392 patients undergoing primary TKR, of whom 829 patients (35%) reported back pain. Compared with those patients without back pain, those with back pain were more likely to be female (odds ratio (OR) 1.5 (95% confidence interval (CI) 1.3 to 1.8)), have a greater level of comorbidity, a worse pre-operative OKS (2.3 points (95% CI 1.7 to 3.0)) and worse SF-12 physical (2.0 points (95% CI 1.4 to 2.6)) and mental (3.3 points (95% CI 2.3 to 4.3)) components.

One year post-operatively, those with back pain had significantly worse outcome scores than those without with a mean difference in the OKS of 5 points (95% CI 3.8 to 5.4), in the SF-12 physical component of 6 points (95% CI 5.4 to 7.1) and in the mental component of 4 points (95% CI 3.1 to 4.9). Patients with back pain were less likely to be satisfied (OR 0.62, 95% CI 0.5 to 0.78).

After adjusting for confounding variables, concomitant back pain was an independent predictor of a worse post-operative OKS, and of dissatisfaction. Clinicians should be aware that patients suffering concomitant back pain pre-operatively are at an increased risk of being dissatisfied post-operatively.

Original languageEnglish
Pages (from-to)1632-1639
Number of pages8
JournalBone and Joint Journal
Volume95B
Issue number12
DOIs
Publication statusPublished - Dec 2013

Keywords

  • FORM HEALTH SURVEY
  • REPORTED OUTCOMES
  • ARTHROPLASTY
  • HIP
  • OSTEOARTHRITIS
  • DEPRESSION
  • ARTHRITIS
  • SURGERY
  • BURDEN
  • WOMAC

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