Predictors of undergoing joint replacement surgery among patients with severe osteoarthritis

A progressive, destructive joint disease, osteoarthritis (OA) is a major cause of disability worldwide. Total joint arthroplasty (TJA) is a highly successful and cost-effective procedure for managing OA of the hip and knee. Despite this, analyses of hospital records show variations in the rates of TJA by region, gender, race, and socioeconomic status. While these studies tell us about who is undergoing hip and knee replacement surgery, what's missing is why--a comprehensive, rigorous examination of the predisposing factors affecting TJA rates.

Why do some arthritis sufferers agree to undergo TJA and others resist it? To examine the predictors of time to a first TJA, a team of Canadian researchers, affiliated with the University of Toronto and other research institutes, conducted a population-based study of 2,128 individuals ages 55 and over with disabling OA of the hip and/or knee. Their findings, featured in the October 2006 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), support the need for community-based education about arthritis treatments, including hip and knee replacement surgery.

This groundbreaking study focused on two regions of Ontario--one rural with high rates of TJA and one urban with low rates. It started in 1999 with an established sample of older citizens--1,158 from the country; 970 from the city--with severe hip and/or knee OA and no prior joint replacement. Researchers devoted 7 years to follow up, consisting of annual surveys and check-ups on disease progression, linked with hospital databases to determine whether patients had undergone hip or knee replacement surgery.

Among the study population, 73 percent were women, 96 percent were white, 31 percent were living alone, independently, and nearly 68 percent had a high school education or higher. At baseline,

Contact: Amy Molnar
John Wiley & Sons, Inc.

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