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Peter C. Coyte - One of the best experts on this subject based on the ideXlab platform.
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perceptions of and willingness to consider total joint arthroplasty in a population based cohort of individuals with disabling hip and Knee Arthritis
Arthritis Care and Research, 2004Co-Authors: Gillian A. Hawker, Elizabeth M. Badley, James G. Wright, Peter C. CoyteAbstract:Objective To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA. Methods A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or Knee Arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived Arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire. Results Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR] <75 versus ≥75 years 2.42, P = 0.01); worse perceived Arthritis severity (OR per unit increase 1.30, P < 0.001); perceiving TJA as appropriate for moderate, controlled joint pain (OR 3.29, P = 0.004); walking limited to <1 block (OR 1.99, P = 0.015); the risk of revision as acceptable (OR 3.73, P < 0.001); and friends as an important health information source (OR 2.49, P = 0.01). Conclusions Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.
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Perceptions of, and willingness to consider, total joint arthroplasty in a population-based cohort of individuals with disabling hip and Knee Arthritis
Arthritis Care & Research, 2004Co-Authors: Gillian A. Hawker, Elizabeth M. Badley, James G. Wright, Peter C. CoyteAbstract:Objective To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA. Methods A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or Knee Arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived Arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire. Results Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR]
Gillian A. Hawker - One of the best experts on this subject based on the ideXlab platform.
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A patient-centered perspective on surgery avoidance for hip or Knee Arthritis: lessons for the future.
Arthritis & Rheumatism, 2007Co-Authors: Peri J. Ballantyne, Monique A. M. Gignac, Gillian A. HawkerAbstract:Objective Research indicates that there is a discrepancy between need and patient preference for total joint arthroplasty (TJA), an efficacious and cost-effective treatment for severe hip or Knee Arthritis. To understand this discrepancy, we conducted qualitative research to assess the illness perceptions and preferred accommodations and coping strategies of patients with advanced osteoArthritis who had expressed a preference to avoid TJA. Methods In-depth interviews were conducted with a community sample of 29 men and women who were medically assessed as appropriate candidates for TJA but who had expressed a preference to avoid surgery. Inductive content analysis of text data was used to examine how patients' illness perceptions and preferred coping strategies related to surgery preference. Results Participants frequently rejected the medicalization of Arthritis, normalizing the experience of functional decline and defining it as age normative. Participants drew on a broad set of previous experiences with informal and formal care to make decisions about how to manage their condition. Previous negative encounters in medical and surgical care, including those from a distant past or those experienced vicariously, combined with the perception (reinforced by physicians and others) that doing nothing was a viable option deterred Arthritis-related help seeking in the health care system. Conclusion Individuals with Arthritis may benefit from additional counseling regarding effective medical and surgical treatments. Physicians may better meet patient needs by gauging patient preferences for a combination of self-management strategies and medical interventions.
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Physical therapy services for older adults with at least moderately severe hip or Knee Arthritis in 2 Ontario counties.
The Journal of rheumatology, 2005Co-Authors: J. Denise Power, Cheryl Cott, Elizabeth M. Badley, Gillian A. HawkerAbstract:OBJECTIVE: Physical therapy (PT) is a recommended treatment for the management of Arthritis. We investigated factors related to referral to PT services in people with hip or Knee Arthritis and describe characteristics of treatment received. METHODS: As part of a longitudinal study of the population aged > or = 55 years with at least moderately severe hip or Knee Arthritis in 2 Ontario counties (n = 1350), participants were surveyed in the third year of followup about use of PT. Participants were categorized as to whether they had total joint replacement surgery in the past year (TJR group, n = 52) or did not (non-TJR group, n = 1298). Multivariate logistic regression was used to identify determinants of referral to PT considering sociodemographic characteristics, comorbidity, use of prescribed Arthritis medication, and Arthritis severity (WOMAC summary score). RESULTS: Overall, 18.7% of the cohort was referred to PT in the past year: 65.4% of the TJR group and 16.8% of the non-TJR group. The only significant predictor of PT in the TJR group was current use of prescribed Arthritis medication. Greater Arthritis severity, current use of prescribed Arthritis medication, and greater comorbidity were significant independent predictors of referral to PT for the non-TJR group in multivariate logistic regression. The Ontario Health Insurance Plan paid for the majority of PT received. CONCLUSION: Low rates of referral to PT in the previous year suggest possible underutilization. Further research is needed to examine patterns of use of PT throughout the course of the Arthritis disease process and to examine barriers to PT access.
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perceptions of and willingness to consider total joint arthroplasty in a population based cohort of individuals with disabling hip and Knee Arthritis
Arthritis Care and Research, 2004Co-Authors: Gillian A. Hawker, Elizabeth M. Badley, James G. Wright, Peter C. CoyteAbstract:Objective To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA. Methods A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or Knee Arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived Arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire. Results Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR] <75 versus ≥75 years 2.42, P = 0.01); worse perceived Arthritis severity (OR per unit increase 1.30, P < 0.001); perceiving TJA as appropriate for moderate, controlled joint pain (OR 3.29, P = 0.004); walking limited to <1 block (OR 1.99, P = 0.015); the risk of revision as acceptable (OR 3.73, P < 0.001); and friends as an important health information source (OR 2.49, P = 0.01). Conclusions Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.
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Perceptions of, and willingness to consider, total joint arthroplasty in a population-based cohort of individuals with disabling hip and Knee Arthritis
Arthritis Care & Research, 2004Co-Authors: Gillian A. Hawker, Elizabeth M. Badley, James G. Wright, Peter C. CoyteAbstract:Objective To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA. Methods A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or Knee Arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived Arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire. Results Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR]
Chris Pullen - One of the best experts on this subject based on the ideXlab platform.
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Post traumatic Knee Arthritis: Navigated total Knee replacement without hardware removal
The Knee, 2014Co-Authors: Alfonso Manzotti, Chris Pullen, Pietro Cerveri, Cesare Chemello, Norberto ConfalonieriAbstract:Abstract Background The Authors present the results of a series of navigated total Knee replacements (TKR) without hardware removal in patients with post-traumatic Arthritis following femoral fractures. The purpose of the paper was to determine the effectiveness of computer-assisted TKR in these patients compared to routine primary implants. Methods Sixteen patients with post-traumatic Knee Arthritis following a distal femoral fracture and retained hardware were included in the study (group I). Patients in the study group were matched with patients who had undergone a computer navigated TKR using the same implant and software (group II). The indication for TKR in all group II patients was atraumatic Arthritis and surgery was performed in the same period as the study group. Patients were matched for age, gender, pre-operative range of motion, severity of Arthritis pre-operatively, type and grade of deformity and implant features. Results There were no statistically significant differences in surgical time, hospital staying or intra-operative and post-operative complications between the two study groups. At the latest follow-up no statistically significant difference was seen for the Knee Society Score and WOMAC indices. Implant alignment and radiological parameters were similar in both groups. Conclusions This study demonstrated that post-traumatic Knee Arthritis following prior distal femoral fracture can be safely managed using a computer navigated TKR without hardware removal. Comparison between this patient group and a matched group with atraumatic Arthritis showed similar post-operative results and complication rates. Level of evidence: III.
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Navigated shorter incision or smaller implant in Knee Arthritis
Clinical Orthopaedics and Related Research, 2007Co-Authors: Norberto Confalonieri, Alfonso Manzotti, Chris PullenAbstract:Minimally invasive approaches for unicompartmental Knee arthroplasty are well-accepted for treating Knee Arthritis because of the smaller implant size, shorter operative time, and tissue-sparing nature of the procedure. With the introduction of computer alignment systems, a well-aligned and balanced total Knee arthroplasty (TKA) can be achieved even with smaller surgical exposures. We hypothesized a unicompartmental Knee arthroplasty would provide better midterm outcomes than a computer-assisted minimally invasive TKA in patients with isolated medial compartment Knee Arthritis. We matched (preoperative Arthritis severity, age, gender, and preoperative range of motion) 64 Knees that had a medial unicompartmental Knee arthroplasty or a mini-incision computer-assisted TKA. All patients had a varus deformity no greater than 8° and a body mass index lower than 30 kg/m 2 . Patients were followed a minimum of 48 months. In the mini-incision computer-assisted TKA group, all the implants were positioned within 4° of ideal alignment. The surgical time and hospital stay were longer in the computer-assisted TKA group. A unicompartmental Knee arthroplasty was estimated to cost at least 3100 euros (approximately US $4100) less. The clinical assessment showed higher functional and Italian Orthopaedic UKA Users Group scores for the unicompartmental Knee arthroplasty group.
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Navigated shorter incision or smaller implant in Knee Arthritis
Clinical Orthopaedics and Related Research, 2007Co-Authors: Norberto Confalonieri, Alfonso Manzotti, Chris PullenAbstract:Minimally invasive approaches for unicompartmental Knee arthroplasty are well-accepted for treating Knee Arthritis because of the smaller implant size, shorter operative time, and tissue-sparing nature of the procedure. With the introduction of computer alignment systems, a well-aligned and balanced total Knee arthroplasty (TKA) can be achieved even with smaller surgical exposures. We hypothesized a unicompartmental Knee arthroplasty would provide better midterm outcomes than a computer-assisted minimally invasive TKA in patients with isolated medial compartment Knee Arthritis. We matched (preoperative Arthritis severity, age, gender, and preoperative range of motion) 64 Knees that had a medial unicompartmental Knee arthroplasty or a mini-incision computer-assisted TKA. All patients had a varus deformity no greater than 8 degrees and a body mass index lower than 30 kg/m. Patients were followed a minimum of 48 months. In the mini-incision computer-assisted TKA group, all the implants were positioned within 4 degrees of ideal alignment. The surgical time and hospital stay were longer in the computer-assisted TKA group. A unicompartmental Knee arthroplasty was estimated to cost at least 3100 euros (approximately US $4100) less. The clinical assessment showed higher functional and Italian Orthopaedic UKA Users Group scores for the unicompartmental Knee arthroplasty group.
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Unicompartmental versus computer-assisted total Knee replacement for medial compartment Knee Arthritis: a matched paired study
International Orthopaedics, 2006Co-Authors: Alfonso Manzotti, Norberto Confalonieri, Chris PullenAbstract:Patients older than 60 with unicompartmental Knee Arthritis can be treated with total or unicompartmental Knee replacement. The aim of this study was to compare the results of matched paired groups of patients with isolated medial compartment Knee Arthritis replaced with either UKR (group A) or computer-assisted TKR (group B). The results included 68 Knees at a minimum follow-up of 3 years. All patients had a varus deformity no greater than 8o and a BMI lower than 30. Patients were matched in terms of preoperative Arthritis severity, age, gender and preoperative range of motion. In the computer-assisted TKR group, all the implants were positioned within 4o of the correct hip-Knee-ankle angle and frontal tibial component angle. The surgical time and hospital stay were statistically longer in the CA TKR group. During the study no implant required revision. The results showed higher scores for a UKR in the treatment of isolated primary unicompartmental Knee Arthritis in patients older than 60 compared to a computer-assisted TKR. In this study a computer-assisted alignment system for TKR with optimal implant positioning did not produce equivalent clinical results compared to a UKR, but did increase the financial costs.
Norberto Confalonieri - One of the best experts on this subject based on the ideXlab platform.
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Post traumatic Knee Arthritis: Navigated total Knee replacement without hardware removal
The Knee, 2014Co-Authors: Alfonso Manzotti, Chris Pullen, Pietro Cerveri, Cesare Chemello, Norberto ConfalonieriAbstract:Abstract Background The Authors present the results of a series of navigated total Knee replacements (TKR) without hardware removal in patients with post-traumatic Arthritis following femoral fractures. The purpose of the paper was to determine the effectiveness of computer-assisted TKR in these patients compared to routine primary implants. Methods Sixteen patients with post-traumatic Knee Arthritis following a distal femoral fracture and retained hardware were included in the study (group I). Patients in the study group were matched with patients who had undergone a computer navigated TKR using the same implant and software (group II). The indication for TKR in all group II patients was atraumatic Arthritis and surgery was performed in the same period as the study group. Patients were matched for age, gender, pre-operative range of motion, severity of Arthritis pre-operatively, type and grade of deformity and implant features. Results There were no statistically significant differences in surgical time, hospital staying or intra-operative and post-operative complications between the two study groups. At the latest follow-up no statistically significant difference was seen for the Knee Society Score and WOMAC indices. Implant alignment and radiological parameters were similar in both groups. Conclusions This study demonstrated that post-traumatic Knee Arthritis following prior distal femoral fracture can be safely managed using a computer navigated TKR without hardware removal. Comparison between this patient group and a matched group with atraumatic Arthritis showed similar post-operative results and complication rates. Level of evidence: III.
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NAVIGATED SHORTER INCISION OR SMALLER IMPLANT IN Knee Arthritis
2009Co-Authors: Norberto Confalonieri, Alfonso Manzotti, K. MotavalliAbstract:The Authors performed a matched paired study between 2 groups UKR or CA-TKR implanted with a mini-incision (MICA group) in the treatment of isolated medial compartment Knee Arthritis. The Authors hypothesized that UKR offers a real less invasive surgery with lower economical costs despite a worse limb/implant alignment. Furthermore at a minimum 40 months follow-up they hypothesized that this small implant guarantees still both better clinical score and patient satisfaction than in the MICA group. Thirty two patients with isolated medial compartment Knee Arthritis who underwent to a medial UKR from February 2001 to September 2002 were included in the study (UKR group). In all 32 Knees the arthritic change was graded according to the classification of Alback 1 . Arthritic change did not exceed grade IV in the medial compartment and grade II in the patello-femoral compartment. All patients had an asymptomatic patello-femoral joint. All patients had a varus deformity lower than 8° and a body mass index lower than 30. No patient had any clinical evidence of ACL laxity or flexion deformity and all had a preoperative range of motion of a least 110°. At a minimum follow-up of 48 months, every single patients in group A was matched with a patient who had undergone a computer assisted TKR performed with a less invasive approach (shorter than 12 cm) for an isolated medial compartment Knee Arthritis between August 1999 and September 2002 (MICA group) in our hospital. At latest follow-up the clinical outcome was evaluated using both the Knee Society Score and a dedicated UKR score developed by the Italian Orthopaedic UKR Users Group (GIUM). The HKA angle and the Frontal Tibial Component angle (FTC) were measured at latest follow up on long leg standing anterior-posterior radiographs and the mean values between the 2 surgeons assessments were used as final values. Furthermore during the hospital staying we registered in both the groups when each patient was standing comfortably in full weight-bearing according to a self- answered questionnaire and the data were compared. Statistical analysis of the results was performed using parametric test (Student’s t-test). A statistical comparison of the percentage of results for the GIUM score was performed using the Chi-square test. A statistically significant result was given a p≤ 0.05. Both hospital stay and operative time were statistically longer obviously in MICA group. In the UKR group the mean surgical time was 51.5 minutes (range: 36–75) (p At the latest follow-up (minimum 48 months) no statistically significant difference was seen in the postoperative Knee Society score for either group. However, significant differences were seen between the 2 groups in the functional results and in the GIUM score with better results in the UKR group. All the patients achieved a range of motion greater than 120° and could walk for longer distances. During the hospital staying in this group the patients reported a statistically significant earlier full weight-bearing. This was despite a significant less accurate limb alignment. In addition to inferior results for the computer assisted mini-invasive TKR group the costs of the procedure were obviously greater because of the expensive implants and technology along with statistically significant longer surgical times and hospital stay
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Navigated shorter incision or smaller implant in Knee Arthritis
Clinical Orthopaedics and Related Research, 2007Co-Authors: Norberto Confalonieri, Alfonso Manzotti, Chris PullenAbstract:Minimally invasive approaches for unicompartmental Knee arthroplasty are well-accepted for treating Knee Arthritis because of the smaller implant size, shorter operative time, and tissue-sparing nature of the procedure. With the introduction of computer alignment systems, a well-aligned and balanced total Knee arthroplasty (TKA) can be achieved even with smaller surgical exposures. We hypothesized a unicompartmental Knee arthroplasty would provide better midterm outcomes than a computer-assisted minimally invasive TKA in patients with isolated medial compartment Knee Arthritis. We matched (preoperative Arthritis severity, age, gender, and preoperative range of motion) 64 Knees that had a medial unicompartmental Knee arthroplasty or a mini-incision computer-assisted TKA. All patients had a varus deformity no greater than 8° and a body mass index lower than 30 kg/m 2 . Patients were followed a minimum of 48 months. In the mini-incision computer-assisted TKA group, all the implants were positioned within 4° of ideal alignment. The surgical time and hospital stay were longer in the computer-assisted TKA group. A unicompartmental Knee arthroplasty was estimated to cost at least 3100 euros (approximately US $4100) less. The clinical assessment showed higher functional and Italian Orthopaedic UKA Users Group scores for the unicompartmental Knee arthroplasty group.
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Navigated shorter incision or smaller implant in Knee Arthritis
Clinical Orthopaedics and Related Research, 2007Co-Authors: Norberto Confalonieri, Alfonso Manzotti, Chris PullenAbstract:Minimally invasive approaches for unicompartmental Knee arthroplasty are well-accepted for treating Knee Arthritis because of the smaller implant size, shorter operative time, and tissue-sparing nature of the procedure. With the introduction of computer alignment systems, a well-aligned and balanced total Knee arthroplasty (TKA) can be achieved even with smaller surgical exposures. We hypothesized a unicompartmental Knee arthroplasty would provide better midterm outcomes than a computer-assisted minimally invasive TKA in patients with isolated medial compartment Knee Arthritis. We matched (preoperative Arthritis severity, age, gender, and preoperative range of motion) 64 Knees that had a medial unicompartmental Knee arthroplasty or a mini-incision computer-assisted TKA. All patients had a varus deformity no greater than 8 degrees and a body mass index lower than 30 kg/m. Patients were followed a minimum of 48 months. In the mini-incision computer-assisted TKA group, all the implants were positioned within 4 degrees of ideal alignment. The surgical time and hospital stay were longer in the computer-assisted TKA group. A unicompartmental Knee arthroplasty was estimated to cost at least 3100 euros (approximately US $4100) less. The clinical assessment showed higher functional and Italian Orthopaedic UKA Users Group scores for the unicompartmental Knee arthroplasty group.
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Unicompartmental versus computer-assisted total Knee replacement for medial compartment Knee Arthritis: a matched paired study
International Orthopaedics, 2006Co-Authors: Alfonso Manzotti, Norberto Confalonieri, Chris PullenAbstract:Patients older than 60 with unicompartmental Knee Arthritis can be treated with total or unicompartmental Knee replacement. The aim of this study was to compare the results of matched paired groups of patients with isolated medial compartment Knee Arthritis replaced with either UKR (group A) or computer-assisted TKR (group B). The results included 68 Knees at a minimum follow-up of 3 years. All patients had a varus deformity no greater than 8o and a BMI lower than 30. Patients were matched in terms of preoperative Arthritis severity, age, gender and preoperative range of motion. In the computer-assisted TKR group, all the implants were positioned within 4o of the correct hip-Knee-ankle angle and frontal tibial component angle. The surgical time and hospital stay were statistically longer in the CA TKR group. During the study no implant required revision. The results showed higher scores for a UKR in the treatment of isolated primary unicompartmental Knee Arthritis in patients older than 60 compared to a computer-assisted TKR. In this study a computer-assisted alignment system for TKR with optimal implant positioning did not produce equivalent clinical results compared to a UKR, but did increase the financial costs.
Elizabeth M. Badley - One of the best experts on this subject based on the ideXlab platform.
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Physical therapy services for older adults with at least moderately severe hip or Knee Arthritis in 2 Ontario counties.
The Journal of rheumatology, 2005Co-Authors: J. Denise Power, Cheryl Cott, Elizabeth M. Badley, Gillian A. HawkerAbstract:OBJECTIVE: Physical therapy (PT) is a recommended treatment for the management of Arthritis. We investigated factors related to referral to PT services in people with hip or Knee Arthritis and describe characteristics of treatment received. METHODS: As part of a longitudinal study of the population aged > or = 55 years with at least moderately severe hip or Knee Arthritis in 2 Ontario counties (n = 1350), participants were surveyed in the third year of followup about use of PT. Participants were categorized as to whether they had total joint replacement surgery in the past year (TJR group, n = 52) or did not (non-TJR group, n = 1298). Multivariate logistic regression was used to identify determinants of referral to PT considering sociodemographic characteristics, comorbidity, use of prescribed Arthritis medication, and Arthritis severity (WOMAC summary score). RESULTS: Overall, 18.7% of the cohort was referred to PT in the past year: 65.4% of the TJR group and 16.8% of the non-TJR group. The only significant predictor of PT in the TJR group was current use of prescribed Arthritis medication. Greater Arthritis severity, current use of prescribed Arthritis medication, and greater comorbidity were significant independent predictors of referral to PT for the non-TJR group in multivariate logistic regression. The Ontario Health Insurance Plan paid for the majority of PT received. CONCLUSION: Low rates of referral to PT in the previous year suggest possible underutilization. Further research is needed to examine patterns of use of PT throughout the course of the Arthritis disease process and to examine barriers to PT access.
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perceptions of and willingness to consider total joint arthroplasty in a population based cohort of individuals with disabling hip and Knee Arthritis
Arthritis Care and Research, 2004Co-Authors: Gillian A. Hawker, Elizabeth M. Badley, James G. Wright, Peter C. CoyteAbstract:Objective To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA. Methods A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or Knee Arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived Arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire. Results Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR] <75 versus ≥75 years 2.42, P = 0.01); worse perceived Arthritis severity (OR per unit increase 1.30, P < 0.001); perceiving TJA as appropriate for moderate, controlled joint pain (OR 3.29, P = 0.004); walking limited to <1 block (OR 1.99, P = 0.015); the risk of revision as acceptable (OR 3.73, P < 0.001); and friends as an important health information source (OR 2.49, P = 0.01). Conclusions Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.
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Perceptions of, and willingness to consider, total joint arthroplasty in a population-based cohort of individuals with disabling hip and Knee Arthritis
Arthritis Care & Research, 2004Co-Authors: Gillian A. Hawker, Elizabeth M. Badley, James G. Wright, Peter C. CoyteAbstract:Objective To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA. Methods A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or Knee Arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived Arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire. Results Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR]