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Determinants of knee replacement in subjects with a history of arthroscopy: data from the osteoarthritis initiative

  • Original Article • KNEE - EPIDEMIOLOGY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objective

To investigate the risk and determinants of knee replacement (KR) in subjects with or at risk of osteoarthritis (OA) and a history of arthroscopy.

Methods

Data from the osteoarthritis initiative cohort were analyzed (n = 4796, up to the seventh year of follow-up). Cox proportional hazard analysis was used to determine the risk of KR according to the history of arthroscopy. A multivariable model was used to determine the risk factors for KR among subjects with a history of arthroscopy (n = 842), including age, gender, body mass index, history of knee injury, and baseline physical activity scale for the elderly, Western Ontario and McMaster (WOMAC) total score, and radiographic Kellgren and Lawrence (KL) score.

Results

History of arthroscopy was associated with risk of KR after adjustments for the mentioned determinants of OA (HR: 1.90 (1.49–2.44); P value <0.001). Female gender (HR: 1.86 (1.30–2.68); P value <0.001), higher WOMAC (HR: 1.02 (1.01–1.03); P value <0.001), and KL score (HR: 2.64 (2.08–3.35); P value <0.001) increased the risk of KR among subjects with a history of arthroscopy. Subjects with a history of knee injury had 50 % lower risk of KR (HR: 0.50 (0.35–0.72); P value <0.001) after arthroscopy.

Conclusion

Female gender, more clinical symptoms and radiographic signs of OA, was associated with higher risk of future KR in subjects with a history of arthroscopy. Subjects with arthroscopy in the setting of concomitant knee injury were 50 % less likely to undergo KR compared to subjects who underwent arthroscopy without a history of concomitant knee injury.

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Acknowledgments

This study utilizes the publicly accessible datasets from the osteoarthritis initiative (OAI) cohort. The OAI is a public–private partnership comprises five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; and N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript was prepared using an OAI public use dataset and does not necessarily reflect the opinions or views of the OAI investigators, the NIH, or the private funding partners. This study has received no funding. Bashir Zikria, Nima Hafezi-Nejad, John Wilckens, and James Ficke have no conflicts of interest. Shadpour Demehri has grants from GERRAF 2014–2016; Carestream Health Inc. 2013–2015 for Cone—Beam CT clinical trial; Toshiba Medical Systems as a consultant.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Johns Hopkins University, Baltimore, MD, USA

    Bashir Zikria, John Wilckens & James R. Ficke

  2. Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD, USA

    Nima Hafezi-Nejad & Shadpour Demehri

  3. Johns Hopkins Department of Orthopedics, Johns Hopkins University, 4924 Campbell Road Suite 130, Baltimore, MD, 21236, USA

    Bashir Zikria

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  1. Bashir Zikria
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  2. Nima Hafezi-Nejad
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  5. Shadpour Demehri
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Correspondence to Bashir Zikria.

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Zikria, B., Hafezi-Nejad, N., Wilckens, J. et al. Determinants of knee replacement in subjects with a history of arthroscopy: data from the osteoarthritis initiative. Eur J Orthop Surg Traumatol 26, 665–670 (2016). https://doi.org/10.1007/s00590-016-1810-y

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  • DOI: https://doi.org/10.1007/s00590-016-1810-y

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