COMPARATIVE STUDY
JOURNAL ARTICLE

Incidence and outcomes of knee and hip joint replacement in veterans and civilians

Vanessa Wells, Trevor Hearn, Adrian Heard, Kylie Lange, Wayne Rankin, Stephen Graves
ANZ Journal of Surgery 2006, 76 (5): 295-9
16768685

BACKGROUND: This article describes the incidence of total knee and hip replacement, and compares post-surgery health status outcomes in veterans and civilians.

METHODS: The numbers of male veterans and civilians who had a knee and/or a hip replacement in South Australia (1994-2002) were obtained. Standardized morbidity ratios, and odds ratios for age group by veteran/civilian interactions, were calculated. Presurgery and 1-year post-surgery Medical Outcomes Short Form (36) Health Survey, Knee Society and Harris hip scores were completed. Independent samples t-tests were used to compare presurgery scores. ancova models were used to determine any differences between veterans and civilians post-surgery.

RESULTS: For veterans, standardized morbidity ratios were 0.987 and 0.715 for knee and hip replacements, respectively (P < 0.0001). Veterans' odds ratios for knee and hip replacements were significantly lower in the 65- to 74-year age group (P < 0.001), similar in the 75- to 84-year and above 85-year age groups for hip replacement, but significantly higher in the above 85-year age group for knee replacement (P < 0.001). Presurgery, veterans reported significantly lower scores (P < 0.003) for knee function. After knee replacement, veterans reported significantly lower Medical Outcomes Short Form (36) Health Survey scores for bodily pain, physical functioning, role - physical, role--emotional, social functioning and physical component summary (P < 0.033). Significantly lower physical functioning, role--physical and physical component summary scores (P < 0.02) were reported by veterans post-surgery for hip replacement.

CONCLUSION: Veterans are delaying joint replacement. Presurgical knee function is worse in veterans. Post-surgery, the veterans are worse off in a number of health status outcomes.

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