A Predictive Model for Knee Joint Replacement in Older Women
Knee replacement (KR) is expensive and invasive. To date no predictive algorithms have been developed to identify individuals at high risk of surgery. This study assessed whether patient self-reported risk factors predict 10-year KR in a population-based study of 1,462 women aged over 70 years recru...
| Main Authors: | , , , |
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| Format: | Journal Article |
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Public Library of Science
2013
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| Online Access: | http://hdl.handle.net/20.500.11937/48115 |
| _version_ | 1848758021841223680 |
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| author | Lewis, Joshua Dhaliwal, Satvinder Zhu, Kun Prince, Richard |
| author_facet | Lewis, Joshua Dhaliwal, Satvinder Zhu, Kun Prince, Richard |
| author_sort | Lewis, Joshua |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Knee replacement (KR) is expensive and invasive. To date no predictive algorithms have been developed to identify individuals at high risk of surgery. This study assessed whether patient self-reported risk factors predict 10-year KR in a population-based study of 1,462 women aged over 70 years recruited for the Calcium Intake Fracture Outcome Study (CAIFOS). Complete hospital records of prevalent (1980-1998) and incident (1998-2008) total knee replacement were available via the Western Australian Data Linkage System. Potential risk factors were assessed for predicative ability using a modeling approach based on a pre-planned selection of risk factors prior to model evaluation. There were 129 (8.8%) participants that underwent KR over the 10 year period. Baseline factors including; body mass index, knee pain, previous knee replacement and analgesia use for joint pain were all associated with increased risk, (P < 0.001). These factors in addition to age demonstrated good discrimination with a C-statistic of 0.79 ± 0.02 as well as calibration determined by the Hosmer-Lemeshow Goodness-of-Fit test.For clinical recommendations, three categories of risk for 10-year knee replacement were selected; low < 5%; moderate 5 to < 10% and high ≥ 10% predicted risk. The actual risk of knee replacement was; low 16 / 741 (2.2%); moderate 32 / 330 (9.7%) and high 81 / 391 (20.7%), P < 0.001. Internal validation of this 5-variable model on 6-year knee replacements yielded a similar C-statistic of 0.81 ± 0.02, comparable to the WOMAC weighted score; C-statistic 0.75 ± 0.03, P = 0.064. In conclusion 5 easily obtained patient self-reported risk factors predict 10-year KR risk well in this population. This algorithm should be considered as the basis for a patient-based risk calculator to assist in the development of treatment regimens to reduce the necessity for surgery in high risk groups such as the elderly. |
| first_indexed | 2025-11-14T09:37:22Z |
| format | Journal Article |
| id | curtin-20.500.11937-48115 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:37:22Z |
| publishDate | 2013 |
| publisher | Public Library of Science |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-481152017-09-13T14:20:52Z A Predictive Model for Knee Joint Replacement in Older Women Lewis, Joshua Dhaliwal, Satvinder Zhu, Kun Prince, Richard Knee replacement (KR) is expensive and invasive. To date no predictive algorithms have been developed to identify individuals at high risk of surgery. This study assessed whether patient self-reported risk factors predict 10-year KR in a population-based study of 1,462 women aged over 70 years recruited for the Calcium Intake Fracture Outcome Study (CAIFOS). Complete hospital records of prevalent (1980-1998) and incident (1998-2008) total knee replacement were available via the Western Australian Data Linkage System. Potential risk factors were assessed for predicative ability using a modeling approach based on a pre-planned selection of risk factors prior to model evaluation. There were 129 (8.8%) participants that underwent KR over the 10 year period. Baseline factors including; body mass index, knee pain, previous knee replacement and analgesia use for joint pain were all associated with increased risk, (P < 0.001). These factors in addition to age demonstrated good discrimination with a C-statistic of 0.79 ± 0.02 as well as calibration determined by the Hosmer-Lemeshow Goodness-of-Fit test.For clinical recommendations, three categories of risk for 10-year knee replacement were selected; low < 5%; moderate 5 to < 10% and high ≥ 10% predicted risk. The actual risk of knee replacement was; low 16 / 741 (2.2%); moderate 32 / 330 (9.7%) and high 81 / 391 (20.7%), P < 0.001. Internal validation of this 5-variable model on 6-year knee replacements yielded a similar C-statistic of 0.81 ± 0.02, comparable to the WOMAC weighted score; C-statistic 0.75 ± 0.03, P = 0.064. In conclusion 5 easily obtained patient self-reported risk factors predict 10-year KR risk well in this population. This algorithm should be considered as the basis for a patient-based risk calculator to assist in the development of treatment regimens to reduce the necessity for surgery in high risk groups such as the elderly. 2013 Journal Article http://hdl.handle.net/20.500.11937/48115 10.1371/journal.pone.0083665 Public Library of Science unknown |
| spellingShingle | Lewis, Joshua Dhaliwal, Satvinder Zhu, Kun Prince, Richard A Predictive Model for Knee Joint Replacement in Older Women |
| title | A Predictive Model for Knee Joint Replacement in Older Women |
| title_full | A Predictive Model for Knee Joint Replacement in Older Women |
| title_fullStr | A Predictive Model for Knee Joint Replacement in Older Women |
| title_full_unstemmed | A Predictive Model for Knee Joint Replacement in Older Women |
| title_short | A Predictive Model for Knee Joint Replacement in Older Women |
| title_sort | predictive model for knee joint replacement in older women |
| url | http://hdl.handle.net/20.500.11937/48115 |