Identification of early prognostic factors for knee and hip arthroplasty; a long-term follow-up of the CHECK cohort
Danial Zarringam,a Daniel B.F. Saris,b and Joris E.J. Bekkersc,∗Hip Knee
Background
Patients with the clinical symptoms of knee or hip osteoarthritis without solid X-ray features present a therapeutic dilemma. The question arises whether the decision for a surgical treatment should be based on the clinical presentation or the X-ray.
Objective
To determine prognostic patient factors for knee and hip arthroplasty when the X-ray does only show Kellgren and Lawrence grade 0–2 osteoarthritis.
Study design
Nationwide prospective cohort study.
Methods
Participants of the Cohort Hip and Cohort Knee (CHECK) with KL 0–2 osteoarthritis on the X-ray were contacted to determine whether any knee or hip arthroplasty had taken place. A Cox proportional hazards regression analysis was performed to find baseline patient factors predicting the decision for arthroplasty.
Results
Regarding the knee, sex HR 0.207 P = 0.030, BMI HR 1.081 P = 0.018 and WOMAC total sum score HR 1.022 P = 0.017 were statistically significant predictors of the outcome arthroplasty. Age was not a significant predictor (P = 0.079). Concerning the hip, sex HR 2.103 P = 0.012, age HR 1.062 P = 0.022 and WOMAC total sum score HR 1.019 P = 0.029 were found to be statistically significant predictors for arthroplasty. BMI (P = 0.576), contralateral pain (P = 0.877) and health perception (P = 0.405) did not predict the end point hip arthroplasty.
Conclusion
Predictors for knee arthroplasty were being female, having a higher BMI and a higher WOMAC total sum score. Predictors for hip arthroplasty were being male, having a higher age and a higher WOMAC total sum score. The incidence of arthroplasty was 5.1% (10.2 years) for the knee and 10.2% (9.7 years) for the hip.
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