title: Factors related with the time to surgery in waiting-list patients for knee prostheses.
abstract: OBJECTIVE
  In the year 2006 the Hospital Complex of Jaén began a new model of attention for consultation of knee osteoarthritis (CMAR), to offer quality treatment to the patient based on clinical practice guidelines. The objective of this study was to analyse the efficiency of the unit, in terms of delaying the time until a knee prostheses is needed.
  
  
  METHODS
  An analysis of a retrospective cohort of patients seen at the CMAR was made, with a minimum available data set, and a Kaplan Meier analysis carried out in order to evaluate the time until the referral of the patient to surgery, as well as a Cox regression analysis in order to study the factors related with the time until the referral.
  
  
  RESULTS
  224 patients were included, with mean age of 65.7 years (95% CI 64 to 67), 67.9% women. 48.2% had a stage III affection (Kellgren-Lawrence), 27.5% stage 2, 15.3% stage 4, and 9% stage 1. 90.2% (202) received treatment with viscosupplementation (Hialuronic acid NASHA). Single joint affection (P<.0001; OR 0,267, 95% CI 0.130 to 0,549), a higher degree of osteoarthritis (P=.048; OR 0,410, 95% CI 0.169 to 0,992), and lower intensity of pain (P<.0001; OR 1,091, 95% CI 1.044 to 1,141), were the factors related with shorter time until surgery. Treatment with viscosupplementation increased the time until surgery in all patients.
  
  
  CONCLUSIONS
  Factors like a lower age of the patient and the involvement of a single joint influenced the referral of the patient to surgery. The administration of viscosupplementation, delayed the time until the patient was finally referred to surgery.
authors: Unidad de Artrosis de Rodilla, Sección de Reumatología, Complejo Hospitalario de Jaén, Jaén, España. mromero@saludalia.com
authors: Manuel
authors: M
authors: Romero Jurado
authors: Alejandro
authors: A
authors: Enrique Fidalgo
authors: Virginia
authors: V
authors: Rodríguez Villar
authors: Javier
authors: J
authors: Mar Medina
authors: Begoña
authors: B
authors: Soler López
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery* / Q000628:therapy; D016016:Proportional Hazards Models; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D055676:Viscosupplementation; D014850:Waiting Lists