title: Socioeconomic status affects the Oxford knee score and short-form 12 score following total knee replacement.
abstract: We assessed the effect of social deprivation upon the Oxford knee score (OKS), the Short-Form 12 (SF-12) and patient satisfaction after total knee replacement (TKR). An analysis of 966 patients undergoing primary TKR for symptomatic osteoarthritis (OA) was performed. Social deprivation was assessed using the Scottish Index of Multiple Deprivation. Those patients that were most deprived underwent surgery at an earlier age (p = 0.018), were more likely to be female (p = 0.046), to endure more comorbidities (p = 0.04) and to suffer worse pain and function according to the OKS (p < 0.001). In addition, deprivation was also associated with poor mental health (p = 0.002), which was assessed using the mental component (MCS) of the SF-12 score. Multivariable analysis was used to identify independent predictors of outcome at one year. Pre-operative OKS, SF-12 MCS, back pain, and four or more comorbidities were independent predictors of improvement in the OKS (all p < 0.001). Pre-operative OKS and improvement in the OKS were independent predictors of dissatisfaction (p = 0.003 and p < 0.001, respectively). Although improvement in the OKS and dissatisfaction after TKR were not significantly associated with social deprivation per se, factors more prevalent within the most deprived groups significantly diminished their improvement in OKS and increased their rate of dissatisfaction following TKR.
authors: University of Edinburgh, Department of Orthopaedics, The Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh EH16 4SU, UK. nickclement@doctors.org.uk
authors: N D
authors: ND
authors: Clement
authors: P J
authors: PJ
authors: Jenkins
authors: D
authors: D
authors: MacDonald
authors: Y X
authors: YX
authors: Nie
authors: J T
authors: JT
authors: Patton
authors: S J
authors: SJ
authors: Breusch
authors: C R
authors: CR
authors: Howie
authors: L C
authors: LC
authors: Biant
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019645:Arthroplasty, Replacement, Knee; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020370:Osteoarthritis, Knee / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D016896:Treatment Outcome