The effect of obesity on quality-of-life improvement after total knee arthroplasty.

Obesity has been consistently implicated as a major risk factor in the development and progression of osteoarthritis (OA), and total joint arthroplasty (TJA) has emerged as one of the most efficacious and cost-effective OA treatments. The effectiveness of this treatment manifests itself in both clinical and quality of life (QOL) measures. Given the interrelatedness of obesity and OA, and given the success of TJA in improving QOL, we conducted a study to determine whether obesity would adversely affect QOL improvement in 50 patients who underwent primary total knee arthroplasty for primary knee OA.

Using self-assessed health to predict patient outcomes after total knee replacement.

Self-assessed health status has been shown to be a powerful predictor of mortality, service use, and total cost of medical care treatment. We investigated the potential for self-assessed health to further serve as a predictor of improvement in health status after a clinical intervention. Using the five-category measure of self-assessed health (excellent, very good, good, fair, or poor), we examined patients' improvements in health status after total knee arthroplasty in each of the WOMAC-defined categories for health status in patients.

Marital status and health care expenditures among the elderly in a managed care organization.

The purpose of this study was to determine the relationship of marital status in and health care expenditures among the elderly in a managed care organization. The study population consisted of 277 functionally impaired elderly people who were 75 years and older enrolled in a managed care organization. In separate analyses, the relationship between marital status and total expenditure per enrollee, the number of outpatient visits, hospital admissions, and emergency department (ED) visits during the two-year study period was examined.