Severe other joint disease and obesity independently influence recovery after joint replacement surgery: an observational study.
OBJECTIVE
Are either severe other joint disease or obesity associated with a slower rate of recovery after total hip or knee replacement surgery? Are they associated with less absolute recovery up to one year post-surgery?


METHODS
Prospective, longitudinal, observational study over 12 months.


METHODS
Ninety-nine patients (knee=55, hip=44) stratified according to the presence of severe other joint disease and obesity.


METHODS
Pain in operated joint, and 15-m Walk Test and Timed Up and Go Test measured pre- and at 2, 6, 12, 26, and 52 weeks post-surgery. Walking aid utilisation and global improvement were measured at 52 weeks.


RESULTS
For rate of recovery, the participants with severe other joint disease recovered more slowly than the non-severe group in terms of mobility (15-m Walk Test p=0.005). For absolute recovery, participants with severe other joint disease walked 0.27 m/s (95% CI 0.15 to 0.40) more slowly on the 15-m Walk Test, took 4.0 s (95% CI 2.3 to 5.8) longer on the Timed Up and Go Test, and had 6.8 times greater chance (95% CI 2.8 to 16.5) of using a walking aid than the non-severe group at 52 weeks. This profile was similar for the obese group compared with the non-obese group. At 52 weeks, the majority (95%) of participants reported significant (better/much better) global improvement.


CONCLUSIONS
Severe other joint disease and obesity are associated with poorer recovery after surgery. Clinician and patient expectations, rehabilitation, and benchmarking can be guided by these findings.
Naylor
Justine M
JM
Joint Replacement Centre, Sydney South West Area Health Service, Orthopaedic Department, Liverpool Hospital, Australia. Justine.Naylor@sswahs.nsw.gov.au
Harmer
Alison R
AR
Heard
Roc C
RC
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome