Journal of Bone and Mineral Metabolism

, Volume 32, Issue 2, pp 192–199 | Cite as

Disability for daily living is a predictor for joint replacement in patients with end-stage knee osteoarthritis

  • Lizu Liu
  • Muneaki Ishijima
  • Haruka Kaneko
  • Ippei Futami
  • Ryo Sadatsuki
  • Shinnosuke Hada
  • Anwarjan Yusup
  • Yukio Shimura
  • Mitsuaki Kubota
  • Yoshitomo Saita
  • Yuji Takazawa
  • Hiroshi Ikeda
  • Hisashi Kurosawa
  • Kazuo Kaneko
Original Article

Abstract

The objective indicators which reflect the past results of end-stage knee osteoarthritis (OA) patients who have already received total knee arthroplasty (TKA) could be helpful for physicians to discuss with patients who are considering TKA. The aim of this prospective cohort study was to examine whether we could predict the knee OA patients who would receive TKA in advance based on baseline data, and to set cut-off points for receiving TKA. The two-hundred and forty end-stage medial-type knee OA patients were enrolled and followed up for 6 months while performing therapeutic exercises. Radiographic findings, visual analog scale for pain and a patient-oriented outcome measure, the Japanese Knee Osteoarthritis Measure (JKOM), were recorded at baseline. Relative risks (RRs) using the area under the curve (AUC) for a receiver operating characteristic (ROC) curve were calculated to evaluate several scores for receiving TKA. While 119 patients (55.3 %) did not undergo TKA, the remaining 96 patients (44.7 %) underwent TKA during this period. The AUCs of the ROC curve for the JKOM total score [0.71 (95 % CI 0.64–0.79)] were higher than those for radiographic parameters. Among the JKOM subcategories, JKOM category III, which indicates the condition in daily life, showed the highest AUC of 0.72 (0.65–0.80). The JKOM total score (65/100) and JKOM category III score (17/40) showed RRs of 2.20 (1.33–3.63) and 1.95 (1.18–3.22) for receiving TKA, respectively. The presence of disability in daily living was found to be an important factor determining whether the patient should undergo TKA.

Keywords

Knee osteoarthritis Japanese knee osteoarthritis measure (JKOM) Total knee arthroplasty (TKA) Disability Pain 

Notes

Acknowledgments

We wish to thank for Dr. Takayuki Kawasaki for his valuable help in data collection. This study was funded in part by a High Technology Research Center Grant from the Ministry of Education, Culture, Sports, Science and Technology, Japan (to MI and KK).

Conflict of interest

All authors have no conflicts of interest.

Supplementary material

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Supplementary material 1 (TIFF 550 kb)
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Supplementary material 3 (TIFF 901 kb)

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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2013

Authors and Affiliations

  • Lizu Liu
    • 1
    • 2
  • Muneaki Ishijima
    • 1
    • 2
  • Haruka Kaneko
    • 1
  • Ippei Futami
    • 1
  • Ryo Sadatsuki
    • 1
  • Shinnosuke Hada
    • 1
  • Anwarjan Yusup
    • 1
  • Yukio Shimura
    • 3
  • Mitsuaki Kubota
    • 1
  • Yoshitomo Saita
    • 1
  • Yuji Takazawa
    • 1
  • Hiroshi Ikeda
    • 1
  • Hisashi Kurosawa
    • 3
  • Kazuo Kaneko
    • 1
    • 2
  1. 1.Department of Medicine for Orthopaedics and Motor OrganJuntendo University Graduate School of MedicineTokyoJapan
  2. 2.Sportology CenterJuntendo University Graduate School of MedicineTokyoJapan
  3. 3.Department of OrthopaedicsJuntendo Tokyo Metropolitan Koto Geriatric Medical CenterTokyoJapan

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