Pain and overall health status in older people with hip and knee replacement: a population perspective.
Linsell L., Dawson J., Zondervan K., Rose P., Carr A., Randall T., Fitzpatrick R.
OBJECTIVE: To investigate the health-related quality of life and presence of hip or knee pain according to whether or not people had had previous hip or knee arthroplasty. STUDY DESIGN AND SETTING: Cross-sectional survey representing randomly selected sample of 5500 elderly (65+) people. Pain prevalence rates obtained from standard screening questions. Standard pain severity ratings obtained for each hip and knee. RESULTS: People with a past arthroplasty had worse health status compared to other people (p < 0.001 for all but two SF-36 dimensions). Hip or knee pain was more prevalent amongst people with past hip or knee replacement than amongst those without (62.5% versus 36.5% respectively; following adjustment for age and sex: Mantel-Haenszel combined odds ratio = 2.90, 95% CI 2.30-3.68, p < 0.001). More replaced knee joints were symptomatic than replaced hip joints (OR = 1.62, p = 0.022). CONCLUSIONS: Elderly people with a past hip or knee arthroplasty have significantly greater health and social care needs than other people--especially those related to pain and mobility. This may reflect the generalised nature of the underlying disease process.