Summary
Objectives
Osteoarthritis (OA) is a common degenerative joint disease, and total knee replacement
(TKR) is a successful surgical intervention for knee OA treatment. However, the risks
of mortality and major cardiovascular events (MACEs) in patients receiving TKR remain
unclear. This study investigated the risks of mortality and MACEs in knee OA patients
who received TKR.
Methods
For this population-based cohort study, the Longitudinal Health Insurance Database
2000 was used. Two million individuals with knee OA defined by ICD-9-CM codes who
received physical therapy between 1999 and 2017 were selected. For propensity score
matching (PSM), we considered the year of knee OA diagnosis, demographics, comorbidities,
co-medications, and knee OA–related hyaluronic acid or physical therapy at baseline.
After PSM, regression analyses were performed to assess the association of mortality
or MACEs with TKR and non-TKR individuals.
Results
We identified patients (n = 189,708) with a new diagnosis of knee OA between 2000 and 2017. In total, 10,314
propensity-score-paired TKR and non-TKR individuals were selected. The PSM cohort
algorithm revealed that the risk of mortality or MACEs was lower in the TKR group
(adjusted hazard ratio: 0.791; 95% confidence interval: 0.755–0.830) than in the non-TKR
group.
Conclusions
Patients with knee OA who received TKR had decreased risks of mortality and MACEs
than those who did not receive TKR. Moreover, the TKR group received a reduced dosage
of nonsteroidal anti-inflammatory drugs at the 1-year follow-up.
Keywords
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Article info
Publication history
Published online: November 16, 2021
Accepted:
September 6,
2021
Received:
March 19,
2021
Identification
Copyright
© 2021 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
