Journal of Public Health Advance Access originally published online on June 29, 2006
Journal of Public Health 2006 28(3):267-273; doi:10.1093/pubmed/fdl020
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Pain and overall health status in older people with hip and knee replacement: a population perspective
Louise Linsell, Medical Statistician1
Jill Dawson, Senior Research Scientist2
Krina Zondervan, MRC Fellow and Epidemiologist3
Peter Rose, General Practitioner and University Lecturer4
Andrew Carr, Nuffield Professor of Orthopaedic Surgery5
Tony Randall, General Practitioner and Senior Research Fellow6
Ray Fitzpatrick, Professor7
1 Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford, Oxford OX2 6UD, UK
2 Division of Public Health and Primary Health Care, University of Oxford, Old Road, Oxford OX3 7LF, UK
3 Wellcome Trust Centre for Human Genetics, University of Oxford, UK
4 Division of Public Health and Primary Health Care, University of Oxford, Old Road, Oxford OX3 7LF, UK
5 Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Oxford OX3 7LD, UK
6 Division of Public Health and Primary Health Care, Old Road, Oxford OX3 7LF, UK
7 Division of Public Health and Primary Health Care, University of Oxford, UK
Address correspondence to Jill Dawson, E-mail: jill.dawson{at}dphpc.ox.ac.uk
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.
Keywords: hip, knee, pain, prevalence, survey