Factors related with the time to surgery in waiting-list patients for knee prostheses

Reumatol Clin. May-Jun 2013;9(3):148-55. doi: 10.1016/j.reuma.2012.09.003. Epub 2013 Feb 27.
[Article in En, Spanish]

Abstract

Objective: In the year 2006 the Hospital Complex of Jaén began a new model of attention for consultation of knee osteoarthritis (CMAR), to offer quality treatment to the patient based on clinical practice guidelines. The objective of this study was to analyse the efficiency of the unit, in terms of delaying the time until a knee prostheses is needed.

Patients and methods: An analysis of a retrospective cohort of patients seen at the CMAR was made, with a minimum available data set, and a Kaplan Meier analysis carried out in order to evaluate the time until the referral of the patient to surgery, as well as a Cox regression analysis in order to study the factors related with the time until the referral.

Results: 224 patients were included, with mean age of 65.7 years (95% CI 64 to 67), 67.9% women. 48.2% had a stage III affection (Kellgren-Lawrence), 27.5% stage 2, 15.3% stage 4, and 9% stage 1. 90.2% (202) received treatment with viscosupplementation (Hialuronic acid NASHA). Single joint affection (P<.0001; OR 0,267, 95% CI 0.130 to 0,549), a higher degree of osteoarthritis (P=.048; OR 0,410, 95% CI 0.169 to 0,992), and lower intensity of pain (P<.0001; OR 1,091, 95% CI 1.044 to 1,141), were the factors related with shorter time until surgery. Treatment with viscosupplementation increased the time until surgery in all patients.

Conclusions: Factors like a lower age of the patient and the involvement of a single joint influenced the referral of the patient to surgery. The administration of viscosupplementation, delayed the time until the patient was finally referred to surgery.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee* / instrumentation
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Knee Prosthesis
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery*
  • Osteoarthritis, Knee / therapy
  • Proportional Hazards Models
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Time Factors
  • Viscosupplementation
  • Waiting Lists*