title: The effects of total knee arthroplasty on physical functioning and health among the under age 65 population.
abstract: OBJECTIVE
  This study examined the effects of total knee arthroplasty on six measures of physical functioning, self-rated health, pain, earnings, and employment status among US adults aged 51 to 63 years at baseline.
  
  
  METHODS
  Data came from the Health and Retirement Study, a nationally representative longitudinal study conducted biannually. The analysis sample consisted of individuals aged 51 to 63 years at baseline with arthritis who were resurveyed at 2-year intervals from 1996 to 2010. Propensity score matching was used to compare outcomes of persons receiving total knee arthroplasty (TKA) with those of matched controls. Six measures of physical functioning were examined: lower-body mobility problems, instrumental activities of daily living limitations, activities of daily living limitations, and large muscle, fine motor, and gross motor limitations. Self-rated health and pain were also examined. The two employment-related outcomes were earnings and employment status.
  
  
  RESULTS
  Receipt of TKA was associated with better outcomes for several measures of physical functioning, especially mobility limitations, pain, and self-rated health. Receipt of TKA was not associated with increased earnings or employment.
  
  
  CONCLUSIONS
  Receipt of TKA yields important improvements in physical function among persons with an arthritis diagnosis who received the procedure before reaching the age of 65 years. This study contributes to knowledge about the benefits of TKA in a community setting among nonelderly recipients of TKA.
authors.affiliation: Department of Sociology and Center for the Study of Aging, Duke University, Durham, NC.
authors.forename: Linda K
authors.initials: LK
authors.lastname: George
authors.affiliation: Center for the Study of Aging, Duke University, Durham, NC.
authors.forename: Linyan
authors.initials: L
authors.lastname: Hu
authors.affiliation: Department of Economics and Center for the Study of Aging, Duke University, Durham, NC. Electronic address: fsloan@duke.edu.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Sloan
mesh_terms: D000203:Activities of Daily Living; D001168:Arthritis / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D003625:Data Collection; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D020370:Osteoarthritis, Knee / Q000601:surgery; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D057216:Propensity Score; D057566:Self Report; D016896:Treatment Outcome
keywords: pain; physical functioning; quality of life; total knee arthroplasty