https://www.josam.org/josam <div dir="ltr"> <div dir="ltr"> <div class="gmail_quote"> <div id="m_-797128392638846533wmQuoteWrapper"> <div dir="ltr"> <div>The Journal of Science and Medicine (JoSaM) is a peer-reviewed journal dedicated to reporting a broad spectrum of research in the scientific and medical fields.&nbsp; Basic science, translational research and clinical findings are all of interest to the Journal, with a particular emphasis on neuroscientific principles and how they can be applied to investigate questions related to medicine. JoSaM provides authors a place to share with fellow&nbsp;researchers and healthcare professionals the most recent advances in health science and draw speculative conclusions regarding the implications of their scientific findings.&nbsp;</div> </div> </div> </div> </div> </div> Mark Tommerdahl en-US The Journal of Science and Medicine 2690-2656 https://www.josam.org/josam/article/view/114 <p style="font-weight: 400;"><strong>Background<em><br></em></strong>The Alberta Bone and Joint Health Institute (ABJHI) has a comprehensive registry capturing clinical, demographic, and patient-reported outcome measures on all knee arthroplasties performed in the province of Alberta, Canada. This large database provides an opportunity to study the outcomes of total knee arthroplasties (TKA) in patients who underwent unilateral or bilateral procedures.</p> <p style="font-weight: 400;"><strong>Methods<em><br></em></strong>Pain and quality of life outcomes of 29,157 TKAs performed in 23,033 patients for knee osteoarthritis performed in Alberta, Canada from January 2013 to February 2020 were examined. This study: (1) investigates whether having both knees replaced results in better pain and quality of life outcomes than replacing only one knee (using multivariate analysis of variance) and (2) identifies if pain and quality of life outcomes impact the likelihood of needing surgery in the contralateral knee after a first TKA (using univariate and multivariate Cox proportional hazards models). Patient-reported outcomes were measured using questionnaires: the Western Ontario and McMaster Universities Arthritis Index (WOMAC) to assess knee pain, and the EuroQol-5D-5L (EQ-5D) to assess quality of life.</p> <p style="font-weight: 400;"><strong>Results<em><br></em></strong>Patients who had surgery on both knees had approximately 5% better WOMAC (pain) and EQ-5D (quality of life) questionnaire scores 12 months post-surgery than those who had surgery on only one knee. Additionally, for every 1-point higher pre-operative WOMAC pain score (i.e., less pain) there was a 1% decreased likelihood of undergoing a contralateral TKA compared to a 46% decreased likelihood per 1-point improvement in quality of life. Dementia, back pain, and hospital readmission were associated with a 68%, 17%, and 44% decreased likelihood of contralateral TKA respectively. By contrast, patients with obesity were 36% more likely to undergo bilateral TKA (p &lt; 0.05).</p> <p style="font-weight: 400;"><strong>Conclusions<em><br></em></strong>Preoperative knee pain and quality of life play a statistically significant role in determining which patients undergo bilateral TKA. Additionally, bilateral TKA resulted in better patient-reported outcomes compared to unilateral TKA. Though clinical significance cannot be drawn from the low response rates for the patient-reported outcomes, these findings provide a basis for future research on patient-reported outcomes within the Canadian healthcare system.</p> Samantha A Leech Akashroop Khaira Spencer Epp Geoff Schneider Jason Werle Richard Ng Ashley D Harris Sarah L Manske Copyright (c) 2024 The Journal of Science and Medicine 2024-05-21 2024-05-21 5 1 10.37714/josam.v4i1.114