Is Postoperative Function After Hip or Knee Arthroplasty Influenced by Preoperative Functional Levels?
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Patient Selection
Primary hip or knee arthroplasty patients with available preoperative, 1, 2, and 3 year postoperative evaluations were selected from a joint registry maintained by the senior author (N = 127) over a 5-year period. All patients gave written consent, which was approved by the institutional review board at Mercy Hospital. Inclusion criteria were those individuals having primary unilateral joint arthroplasty secondary to knee or hip joint osteoarthritis. Exclusion criteria were those individuals
Hip
Twenty-four individuals had preoperative WOMAC physical function dimension scores of 51 or greater and made up the WF group (n = 24). The average age of this group was 59.67 ± 16.22 years; there were 12 women and 12 men. The average age of the HF group (n = 38) was 61.11 ± 16.23 years; 16 were women and 22 were men. Diagnoses for hip arthroplasty by group is presented in Table 1. Range of motion and frequency of assistive device usage before and after surgery, for both WF and HF groups, are
Discussion
Optimal timing of arthroplasty surgery will have an impact on costs as well as on outcomes. For example, poor preoperative functional status in patients with rheumatoid arthritis who are undergoing total hip or knee arthroplasty is predictive of longer hospital length of stay [6]. Escalante and Beardmore [6] also demonstrated that surgery performed before failure of conservative treatments may decrease length of hospital stay and minimize postsurgical loss of function. More recently, Fortin et
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Conflict of interest statement: Financial support has been received by the corresponding author: Mercy Hospital, Miami, FL; Zimmer, Inc, Warsaw, IN; and Arthritis Surgery Research Foundation, Inc, Miami, FL. Royalties: Zimmer, Inc. Consultant: Zimmer, Inc.