Abstract
BackgroundKnee arthroplasty is increasing exponentially due to the aging of the population and to the broadening of indications. We aimed to compare physical disability and its evolution over two years in people with knee arthroplasty to that in the general population. A secondary objective was to compare the level of disabilities of people with knee to people with hip arthroplasty.Methodology/Principal Findings16,945 people representative of the French population were selected in 1999 from the French census and interviewed about their level of disability. This sample included 815 people with lower limb arthroplasty. In 2001, 608 of them were re-interviewed, among whom 134 had knee arthroplasty. Among the other participants re-interviewed, we identified 68 who had undergone knee arthroplasty and 145 hip arthroplasty within the last two years (recent arthroplasty). People with knee arthroplasty reported significantly greater difficulties than the general population with bending forward (odds ratio [OR] = 4.7; 95% confidence interval [CI]: 1.7, 12.6), walking more than 500 meters (OR = 6.0; 95% CI: 1.5, 24.7) and carrying 5 kg kilograms for 10 meters (OR = 4.6; 95% CI: 1.3, 16.4). However, the two years evolution in disability was similar to that in the general population for most activities. The level of mobility was similar between people with recent knee arthroplasty and those with recent hip arthroplasty. Nevertheless, people with recent knee arthroplasty reported a lower level of disability than the other group for washing and bending forward (OR = 0.3; 95% CI: 0.1, 0.6 and OR = 0.4; 95% CI: 0.1, 0.9, respectively).Conclusions/SignificancePeople with knee arthroplasty reported a higher risk of disability than the general population for common activities of daily living but a similar evolution. There was no relevant difference between recent knee and hip arthroplasties for mobility.
Highlights
The prevalence of knee replacement is increasing exponentially because of the aging of the population and due to the broadening of indications [1]
Multiple logistic regression models adjusted for age, sex, education, number of chronic conditions and probability of 2001 nonresponse allowed for estimating odds ratios [ORs] and their 95% confidence interval [CI] for 1) the level of disability in all subjects with knee arthroplasty compared to the general population in 2001; 2) the evolution of disability in subjects with knee arthroplasty identified in 1999 compared to the general population; and 3) the comparison of disability and its evolution over two years between subjects with recent knee arthroplasty and those with recent hip arthroplasty
The annual incidence of knee arthroplasty in France is estimated at 0.05%
Summary
The prevalence of knee replacement is increasing exponentially because of the aging of the population and due to the broadening of indications [1]. Cohort studies have confirmed that mobility and relief of pain are improved after knee arthroplasty [3,4,5,6,7], but no study has compared the remaining level of disability after the replacement to that in the general population. Many prospective studies [3,4,5,9,10,11,12,13,14] reported that postoperative improvement in pain relief and physical function were greater for subjects with hip arthroplasty than for those with knee arthroplasty. A secondary objective was to compare the level of disabilities of people with knee to people with hip arthroplasty
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