The impact of comorbidity status on knee function 1 year after total knee arthroplasty: a population-based cohort study

Authors

  • Katrine Glintborg Iversen Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus
  • Rikke Sommer Haaber Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus https://orcid.org/0009-0000-7614-3479
  • Martin Bækgaard Stisen Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus; Department of Clinical Medicine, Aarhus University, Aarhus https://orcid.org/0000-0002-8743-8616
  • André Sejr Klenø Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus; Department of Clinical Medicine, Aarhus University, Aarhus https://orcid.org/0000-0003-4263-0345
  • Martin Lindberg-Larsen Department of Orthopaedic Surgery, Odense University Hospital; University of Southern Denmark, Odense, Denmark https://orcid.org/0000-0002-4483-677X
  • Alma Becic Pedersen Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus; Department of Clinical Medicine, Aarhus University, Aarhus https://orcid.org/0000-0002-3288-9401
  • Inger Mechlenburg Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus; Department of Clinical Medicine, Aarhus University, Aarhus https://orcid.org/0000-0001-5432-8691

DOI:

https://doi.org/10.2340/17453674.2024.40706

Abstract

Background and purpose. Few studies have examined the impact of comorbidity on functional and clinical knee scores after primary total knee arthroplasty (TKA). We compared the effect of having a high Charlson Comorbidity Index (CCI), relative to a low CCI, on changes in the American Knee Society Score (AKSS) functional and clinical scores from baseline to week 52 after TKA in patients with knee osteoarthritis (OA).
Methods: This population-based cohort study included 22,533 patients identified in the Danish Knee Arthroplasty Register from 1997 to 2021. Patients were classified as having low, medium, or high comorbidity based on CCI. The outcome was defined as the mean change (from preoperative to 1-year post-TKA) in functional and clinical knee scores measured by the AKSS (0–100). The association was analyzed using multiple linear regression by calculating mean change scores adjusting for sex, age, weight, cohabiting status, and baseline AKSS.
Results: The prevalence of patients with low, medium, and high comorbidity was 75%, 21%, and 4%, respectively. The mean change score in functional AKSS for patients with high comorbidity was –6 points (95% confidence interval [CI] –7 to –5) compared with low comorbidity. The mean change score in clinical AKSS for patients with high comorbidity was –1 point (CI –2 to 0) compared with low comorbidity.
Conclusion: Patients with knee OA and medium or high comorbidity can expect similar improvements in functional and clinical AKSS after TKA to patients with low comorbidity.

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Published

2024-05-17

How to Cite

Iversen, K. G. ., Haaber, R. S., Stisen, M. B., Klenø, A. S., Lindberg-Larsen, M., Pedersen, A. B., & Mechlenburg, I. (2024). The impact of comorbidity status on knee function 1 year after total knee arthroplasty: a population-based cohort study. Acta Orthopaedica, 95, 243–249. https://doi.org/10.2340/17453674.2024.40706