ArticleOsteoarthritis and cartilage2011
The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement.
Article in Osteoarthritis and cartilage, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
86 citing papers in PubMed, 5 syntheses or guidelines pooled it, 195 citations in OpenAlex.
- Metabolic syndrome, hypertension, and hyperglycemia were positively associated with knee osteoarthritis, while dyslipidemia showed no association with knee osteoarthritis.Clinical rheumatology · 2021Pooled it
- The use of mesenchymal stem cells for cartilage repair and regeneration: a systematic review.Journal of orthopaedic surgery and research · 2017Pooled it
- [Personality and comorbidity: are there "difficult patients" in hip arthroplasty?].Der Orthopade · 2015Pooled it
- The effects of knee arthroplasty on walking speed: a meta-analysis.BMC musculoskeletal disorders · 2012Pooled it
- OARSI-OMERACT initiative: defining thresholds for symptomatic severity and structural changes in disease modifying osteoarthritis drug (DMOAD) clinical trials.Osteoarthritis and cartilage · 2012Pooled it
- Trial
- Trial
- Association between activity limitations and pain in patients scheduled for total knee arthroplasty.BMC musculoskeletal disorders · 2016Trial
- The reason why orthopaedic surgeons perform total knee replacement: results of a randomised study using case vignettes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Trial
- The effect of education and supervised exercise vs. education alone on the time to total hip replacement in patients with severe hip osteoarthritis. A randomized clinical trial protocol.BMC musculoskeletal disorders · 2013Trial
- Total knee replacement plus physical and medical therapy or treatment with physical and medical therapy alone: a randomised controlled trial in patients with knee osteoarthritis (the MEDIC-study).BMC musculoskeletal disorders · 2012Trial
- Review
- Cartilage loss is greater in knees with virtual joint replacement status than in matched controls without.Osteoarthritis and cartilage open · 2025Article
- A virtual knee replacement (vKR) multi-component endpoint for knee osteoarthritis based on patient-reported PROs: Data from the Osteoarthritis Initiative.Osteoarthritis and cartilage · 2025Article
- Incidence and Determinants of Falls Following Hip and Knee Joint Arthroplasty: A Systematic Review and Meta-Analysis.Cureus · 2025Review
- Which Endpoints Should be Applied in Interventional Trials? -: From Single Uni-dimensional Assessment Tailored to a Drug's Mechanism of Action to Multi-Component Measures and Multi-Domain Composites.Osteoarthritis imaging · 2025Article
- Influence of Preoperative Nutritional Status on Surgical Outcomes of Arthroplasty in Geriatric Femoral Neck Fractures.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Correlation of Detachment of Proximal Tibia Superficial Medial Collateral Ligament and Medial Meniscus Extrusion with Knee Osteoarthritis.Journal of orthopaedic case reports · 2024Article
- Hip strengthening exercise dosage is not associated with clinical improvements after total hip arthroplasty - a prospective cohort study (the PHETHAS-1 study).BMC musculoskeletal disorders · 2024Observational
- Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
23 authors at 20 institutions in 12 countries.
Funding
Abstract
objectiveTo assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA).
methods
designInternational cross-sectional study in 10 countries. PATIENTS: Consecutive outpatients with definite hip or knee OA attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified. OUTCOME MEASURES: Pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome Score Physical function Short-form, 0-100). ANALYSES: Comparison of patients with vs without surgeons' indication for TJR. Receiver Operating Characteristic (ROC) curve analyses and logistic regression were applied to determine cut points of pain and disability defining recommendation for TJR.
resultsIn all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 [standard deviation (SD) 10.9] years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes vs no) had worse symptom levels [pain, 55.5 (95% confidence interval 54.2, 56.8) vs. 44.9 (43.2, 46.6), and functional impairment, 59.8 (58.7, 60.9) vs. 50.9 (49.3, 52.4), respectively, both P<0.0001], there was substantial overlap in symptom levels between groups, even when adjusting for radiographic joint status. Thus, it was not possible to determine cut points for pain and function defining 'requirement for TJR'.
conclusionAlthough symptom levels were higher in patients recommended for TJR, pain and functional disability alone did not discriminate between those who were and were not considered to need TJR by the orthopaedic surgeon.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.