title: Total joint arthroplasty and preoperative low back pain.
abstract: Lower extremity osteoarthritis with concomitant low-back pain (LBP) may obscure a clinician's ability to properly evaluate the status of hip or knee osteoarthritis and subsequent total joint arthroplasty (TJA) candidacy. A prospective cohort study was conducted to determine prevalence and severity of preoperative LBP among TJA patients, and the effect of TJA on alleviating LBP. Preoperative moderate to worst imaginable LBP pain on the Oswestry Disability Index (ODI) was significantly higher among hips compared to knees (28.8% vs. 16.1%, P < 0.0001). Compared to knees, hips also saw significant ODI improvement from preoperative to one-year postoperative. TJA candidates with considerable preoperative LBP should be counselled that TJA outcome may be impaired by the coexistence of spine disease, and that residual spine pain may continue following otherwise successful TJA.
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
authors.forename: Phillip
authors.initials: P
authors.lastname: Staibano
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors.forename: Mitch
authors.initials: M
authors.lastname: Winemaker
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Petruccelli
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: de Beer
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: hip arthroplasty; knee arthroplasty; low back pain; osteoarthritis; outcomes; total joint replacement