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Health status after hip or knee arthroplasty
  1. C Jinks,
  2. M Lewis,
  3. P Croft
  1. Primary Care Sciences Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK
  1. Correspondence to:
    Dr C Jinks;
    c.jinks{at}cphc.keele.ac.uk

https://doi.org/10.1136/ard.62.8.700

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    After hip and knee arthroplasty pain and disability still remain higher than in the general population

    Hip and knee problems are a major cause of pain and disability. Although only a minority of sufferers—those with severe symptoms and disability in association with radiographic osteoarthritis—will be candidates for surgery, this still means that in America, for example, 400 000 primary hip and knee arthroplasties are performed each year,1 and the demand is increasing.2 Randomised controlled trials of arthroplasty versus other treatments have not generally been performed, but total hip arthroplasty and total knee arthroplasty procedures are perceived by the public and by health professionals to be largely successful. Follow up studies have confirmed that postoperative levels of pain and disability are consistently lower than preoperative levels.3–7 However a number of small studies have also shown that, despite significant postoperative improvements, levels of pain and disability are higher in those who have undergone arthroplasty than in controls in the general population.8–11 A large interview based study, carried out in France by Boutron and colleagues and reported in this issue of the Annals, has now confirmed this finding.12

    Interview based study

    This new study was undertaken on the back of the French national census. Nearly 17 000 people were interviewed. The authors found that those with previous arthroplasty had persistent difficulties with physical functioning. After adjusting their analysis for age, sex, and a number of other chronic conditions, the group with hip and knee arthroplasty were more likely than those in the general population to have continuing lower limb disabilities (including self care, housekeeping, and mobility difficulties). The broad differences between the arthroplasty group and the general population cannot exclude the possibility that the actual contrasts lie in subgroups of the arthroplasty population. A higher proportion of patients …

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