title: Prevalence of knee problems in the population aged 55 years and over: identifying the need for knee arthroplasty.
abstract: OBJECTIVE
  To determine the prevalence of knee problems in people aged 55 years and over and identify those who should be considered for knee arthroplasty.
  
  
  METHODS
  Postal survey; questionnaires were sent to a multistage stratified probability sample of residents of North Yorkshire Health Authority aged 55 and over.
  
  
  METHODS
  A health district with a population of 210,000 aged 55 and over.
  
  
  RESULTS
  An initial four page postal questionnaire produced an 86% response rate among 18,827 eligible patients. A subsequent detailed questionnaire sent to 1277 patients with knee problems (with a response rate of 78%) then determined the prevalence of severe pain and severe disability. Pain and disability consistent with the need to consider arthroplasty was found in 20.4/1000 (95% confidence interval 18.0 to 23.1); of these, 4.1 (2.7 to 5.8)/1000 had extreme disability. Age and sex specific rates in men who might benefit from arthroplasty were, in those aged 55-64, 12.9 (8.4 to 19.0)/1000; aged 65-74, 12.1 (7.4 to 18.4)/1000; aged 75 and over, 20.3 (12.9 to 30.5)/1000. In women aged 55-64 the rates were 12.9 (8.6 to 18.7)/1000; aged 65-74, 19.6 (13.9 to 26.7)/1000; aged 75 years and over, 42.6 (34.3 to 52.4)/1000.
  
  
  CONCLUSIONS
  Total knee replacement has until recently been considered unreliable and often seen as a last resort for many with severe knee problems. Advances in prosthesis design and surgical and anaesthetic techniques have transformed this procedure into a reliable option with a potential for reducing disability and dependency in a large number of people in the community. Understandably, the prevalence pool of those who may benefit is large; health authorities and, increasingly, general practitioners should consider purchasing more total knee replacement surgery to offer real choice to those in need.
authors.affiliation: Rheumatology and Rehabilitation Research Unit, Research School of Medicine, University of Leeds.
authors.forename: A
authors.initials: A
authors.lastname: Tennant
authors.forename: J
authors.initials: J
authors.lastname: Fear
authors.forename: A
authors.initials: A
authors.lastname: Pickering
authors.forename: M
authors.initials: M
authors.lastname: Hillman
authors.forename: A
authors.initials: A
authors.lastname: Cutts
authors.forename: M A
authors.initials: MA
authors.lastname: Chamberlain
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D004739:England / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007592:Joint Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D015995:Prevalence; D011795:Surveys and Questionnaires