Background Recent studies have demonstrated the association of contralateral extremity strength and contralateral knee pain on outcomes 2-3 years after TKA. To our knowledge, there are no published studies describing the effect of ipsilateral lower extremity joint involvement on medium-term patient-reported outcomes (PROs), i.e., pain and function after hip or knee arthroplasty.
Objectives To assess the association of ipsilateral knee/hip pain on short- and mid-term pain and function outcomes after total hip or knee arthroplasty (THA/TKA)
Methods In this prospectively cohort study, we used the data from the Mayo Clinic Total Joint Registry to assess the association of ipsilateral knee or hip joint involvement with moderate-severe pain and moderate-severe functional limitation at 2- and 5-year follow-up after primary and revision THA and TKA using multivariable-adjusted logistic regression analyses.
Results At 2-year, 3,823 primary THA, 4,701 primary TKA, 1,218 revision THA and 725 revision TKA were studied. After adjusting for multiple covariates, ipsilateral knee pain was significantly associated with outcomes after primary THA (all p-values <0.01): (1) moderate-severe pain: at 2-years, odds ratio (OR), 2.3 [95% confidence interval (CI), 1.5, 3.6]; at 5-years, OR 1.8 [95% CI:1.1, 2.7]; (2) moderate-severe functional limitation: at 2-years, OR 3.1 [95% CI:2.3, 4.3]; at 5-years, OR 3.6 [95% CI:2.6, 5.0]. Ipsilateral hip pain was significantly associated with outcomes after primary TKA (all p-values <0.01): (1) moderate-severe pain: at 2-years, OR 3.3 [95% CI:2.3, 4.7] ]; at 5-years, OR 1.8 [95% CI:1.1, 2.7]; (2) moderate-severe functional limitation: at 2-years, OR 3.6 [95% CI:2.6, 4.9]; at 5-years, OR 2.2 [95% CI:1.6, 3.2]. Similar associations were noted for revision THA and TKA patients.
Conclusions Presence of ipsilateral joint involvement after THA or TKA is strongly associated with poor pain and function outcomes. A potential way to improve outcomes is to address ipsilateral lower extremity joint involvement.
Disclosure of Interest None Declared
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