Younger TJR population does not suggest less complex patient pool
Younger patients report the same or greater joint-specific and global pain and decreased function pre-operatively when compared to older adults. In addition, patients under 65 years of age are more obese and more likely to smoke as compared to older patients. Overall, younger patients pose similar risks as older patients, and have similar successful outcomes.
Patient self-reported pain and function scores are remarkably consistent across surgeons before TJR.
Despite the rapid growth in TJR utilization in the US, our analysis suggests surgeons use comparable indications for surgery. Across 150 surgeons, the mean pre-operative pain and function were similar. Overall, more than 92% of patients report significant pain and functional limitations, with the remaining patients reporting quality of life limitations. Monitoring pre-operative PROs can help patients and surgeons determine the optimal time for TJR.
Good pain relief and functional gains for patients with a BMI higher than 35.
While greater BMI is a risk factor for peri-operative complications, FORCE-TJR found that at 6 months after total hip or knee replacement patients with a BMI higher than 35 also reported significant gains in pain relief and physical function.
Negative impact of musculoskeletal comorbidities
The burden of musculoskeletal comorbidities- specifically moderate or severe pain in the lumbar spine and non-operative hips and knees- is associated with poorer function at 6 months after surgery. Future public comparisons of PROs after TJR must be cautious to adjust for co-existing musculoskeletal conditions that can limit functional gain after successful surgery in one knee or hip.