title: Concomitant low back pain impairs outcomes after primary total knee arthroplasty in patients over 65 years: a prospective, matched cohort study.
abstract: BACKGROUND
  Knee osteoarthritis and low back pain (LBP) are two conditions with relatively high prevalence in patients over 65 years. The objective was to determine the effect of symptomatic LBP on the patient-reported outcome after primary TKA.
  
  
  METHODS
  A cohort of 48 patients with concomitant LBP was prospectively matched 1:2 with patients without LBP for gender, age, body mass index and preoperative knee function. LBP severity was measured with the Oswestry Disability Index (ODI). Patient-reported outcomes were assessed with reduced Short-Form (SF12), Western Ontario and McMaster Universities score (WOMAC), and visual analogue scale (VAS) for satisfaction. Functional outcome was assessed with the Knee Society Scores (KSS).
  
  
  RESULTS
  The mean postoperative follow-up was 3.2 years. At last follow-up, LBP cohort had significantly worse SF12, WOMAC, KSS and VAS scores than those patients without LBP. Preoperative ODI score was significantly correlated with outcomes.
  
  
  CONCLUSIONS
  Worse functional and patient-reported outcomes were obtained in patients over 65 years with concomitant LBP, and this was related to the intensity of preoperative LBP. Despite successful outcome in the knee, the LBP usually remains after TKA and this may impair satisfaction and patient-reported outcomes. These patients should be properly informed about their potential outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Collados-Maestre
authors.affiliation: Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain. lizaur1@telefonica.net.|Department of Orthopaedia and Traumatology, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain. lizaur1@telefonica.net.
authors.forename: A
authors.initials: A
authors.lastname: Lizaur-Utrilla
authors.affiliation: Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Martinez-Mendez
authors.affiliation: Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, 03600, Elda, Alicante, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Marco-Gomez
authors.affiliation: Department of Orthopaedia and Traumatology, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain.
authors.forename: F A
authors.initials: FA
authors.lastname: Lopez-Prats
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
keywords: Low back pain; Osteoarthritis; Patient-reported outcome; Total knee arthroplasty