title: Cerebrovascular disease is associated with outcomes after total knee arthroplasty: a US total joint registry study.
abstract: We assessed the association of cerebrovascular disease preoperatively with patient-reported outcomes (PROs) of moderate-severe activity limitation and moderate-severe pain at 2- and 5-years after primary total knee arthroplasty (TKA) using multivariable-adjusted logistic regression; 7139 primary and 4234 revision TKAs were included. Compared to the patients without cerebrovascular disease, those with cerebrovascular disease had a higher odds ratio (OR) of moderate-severe limitation at 2 years and 5 years, 1.32 (95% confidence interval [CI]: 1.02, 1.72; P = .04) and 1.83 (95% CI: 1.32, 2.55; P < .001), respectively. No significant associations were noted with moderate-severe pain at 2 years or 5 years. In conclusion, we found that cerebrovascular disease is independently associated with pain and function outcomes after primary TKA. This should be taken into consideration when discussing expected outcomes of TKA with patients.
authors.affiliation: Medicine Service and Center for Surgical Medical Acute Care Research and Transitions, VA Medical Center, Birmingham, Alabama; Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama, Birmingham, Alabama; Department of Orthopedic, Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
authors.forename: David G
authors.initials: DG
authors.lastname: Lewallen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018771:Arthralgia / Q000150:complications / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D002561:Cerebrovascular Disorders / Q000150:complications*; D059350:Chronic Pain / Q000209:etiology; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D020127:Recovery of Function; D012042:Registries; D057566:Self Report; D016896:Treatment Outcome; D014481:United States
keywords: ADLs; activities of daily living; activity limitation; arthroplasty; cerebrovascular disease; function; functional limitation; joint replacement; outcomes; pain; patient-reported outcomes; total knee replacement