Ipsilateral lower extremity joint involvement increases the risk of poor pain and function outcomes after hip or knee ar
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RESEARCH ARTICLE
Open Access
Ipsilateral lower extremity joint involvement increases the risk of poor pain and function outcomes after hip or knee arthroplasty Jasvinder A Singh1,2,3* and David G Lewallen3
Abstract Background: Poor pain and function outcomes are undesirable after an elective surgery such as total hip or knee arthroplasty (THA/TKA). Recent studies have indicated that the presence of contralateral joint influences outcomes of THA/TKA, however the impact of ipsilateral knee/hip involvement on THA/TKA outcomes has not been explored. The objective of this study was to assess the association of ipsilateral knee/hip joint involvement on short-term and medium-term pain and function outcomes after THA/TKA. Methods: In this retrospective study of prospectively collected data, we used the data from the Mayo Clinic Total Joint Registry to assess the association of ipsilateral knee or hip joint involvement with moderate to severe pain and moderate to severe activity limitation at 2-year and 5-year follow-up after primary and revision THA and TKA using multivariable-adjusted logistic regression analyses. Results: At 2 years, 3,823 primary THA, 4,701 primary TKA, 1,218 revision THA and 725 revision TKA procedures were studied. After adjusting for multiple covariates, ipsilateral knee pain was significantly associated with outcomes after primary THA (all P values 80 years
8%
6%
7%
6%
Age groups, n (%):
Body mass index, kg/m2 ≤25 (normal)
25%
24%
13%
13%
>25 to 29.9 (overweight)
39%
40%
35%
36%
30 to 34.9 (mildly obese)
23%
23%
30%
30%
35 to 39.9 (obese)
8%
8%
14%
14%
≥40 (morbidly obese)
4%
4%
8%
7%
Class I to II
63%
65%
59%
60%
Class III to IV
36%
35%
41%
40%
10%
12%
98%
100%
ASA score:
Implant fixation: Cemented Hybrid
55%
60%
0%
0%
Uncemented
35%
28%
0%
0%
Inflammatory arthritis
2%
3%
3%
4%
Osteoarthritis
88%
86%
96%
93%
Avascular necrosis of bone
7%
7%
-
-
3%
4%
2%
3%
Underlying diagnosis
a
Other
All numbers were rounded to the nearest digit, therefore totals may not exactly add up to 100%. Othera category includes the following: for primary THA: hip dysplasia, Legg-Perthe’s disease, slipped capital femoral epiphyses, failed previous osteotomy, failed previous arthrodeses, failed previous internal fixation, congenital dislocation of hip, pigmented villonodular synovitis, hemochromatosis, synovial chondromatosis, and so on; for primary TKA: genu varum, genu valgum, hemophilia, Paget’s disease, failed previous disease including arthrodesis, failed previous osteotomy, failed previous patellectomy, Chacot arthropathy, chondromalacia, pigmented villonodular synovitis, and so on. ASA, American Society of Anesthesiologists.
Prevalence of ipsilateral knee/hip involvement
Ipsilateral knee involvement was reported in 11% patients at 2 years and 16% patients at 5 years after primary THA. The respective proportions after revision THA were 18% at 2 years and 17% at 5 years. Ipsilateral hip involvement was reported by 12% at 2 years and 13% a
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