Lifetime risk of knee and hip replacement following a GP diagnosis of osteoarthritis : a real-world cohort study
Burn, Edward (University of Oxford. Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS))
Murray, D. W. (Nuffield Department of Orthopaedics. Rheumatology and Musculoskeletal Sciences. University of Oxford)
Hawker, G. A. (Institute for Clinical Evaluative Sciences)
Pinedo-Villanueva, Rafael (University of Oxford. Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS))
Prieto-Alhambra, Daniel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	Objective: The aim of this study was to estimate lifetime risk of knee and hip replacement following a GP diagnosis of osteoarthritis and assess how this risk varies with patient characteristics. Methods: Routinely collected data from Catalonia, Spain, covering 2006 to 2015, were used. Study participants had a newly recorded GP diagnosis of knee or hip osteoarthritis. Parametric survival models were specified for risk of knee/hip replacement and death following diagnosis. Survival models were combined using a Markov model and lifetime risk estimated for the average patient profile. The effects of age at diagnosis, sex, comorbidities, socioeconomic status, body mass index (BMI), and smoking on risk were assessed. Results: 48,311 individuals diagnosed with knee osteoarthritis were included, of whom 2,561 underwent knee replacement. 15,105 individuals diagnosed with hip osteoarthritis were included, of whom 1,247 underwent hip replacement. The average participant's lifetime risk for knee replacement was 30% (95% CI: 25-36%) and for hip replacement was 14% (10-19%). Notable patient characteristics influencing lifetime risk were age at diagnosis for knee and hip replacement, sex for hip replacement, and BMI for knee replacement. BMI increasing from 25 to 35 was associated with lifetime risk of knee replacement increasing from 24% (20-28%) to 32% (26-37%) for otherwise average patients. Conclusion: Knee and hip replacement are not inevitable after an osteoarthritis diagnosis, with average lifetime risks of less than a third and a sixth, respectively. Patient characteristics, most notably BMI, influence lifetime risks.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució i la comunicació pública de l'obra, sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	Osteoarthritis and Cartilage, Vol. 27 Núm. 11 (november 2019) , p. 1627-1635, ISSN 1522-9653

DOI: 10.1016/j.joca.2019.06.004
PMID: 31220608

9 p, 834.6 KB

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