Evidence mapPaperPMID 31362549Full record

Trial reportThe bone & joint journal2019

'Worse than death' and waiting for a joint arthroplasty.

C E H Scott, D J MacDonald, C R Howie

Registry-linked trialOpen access · hybridAbstract readClinical Trial
In one paragraph

Trial report in The bone & joint journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06483178 (A Randomised Controlled Trial Comparing Gait in Fixed or Rotating Cementless Total Knee Arthroplasties), which is not on this map. Cited by 91 papers.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed
22.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06483178 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

A Randomised Controlled Trial Comparing Gait in Fixed or Rotating Cementless Total Knee Arthroplasties

TypeinterventionalSponsorBelfast Health and Social Care TrustRan2025 to 2027Enrolled90ConditionsTotal Knee Arthroplasty, Knee OsteoarthritisArmsAttune knee implant, Triathlon knee implant
3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 169 citations in OpenAlex.

  1. Trial
  2. The silver tsunami and the elective arthroplasty crisis: How geriatric trauma overruns public surgical capacity.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

C E H ScottDepartment of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
D J MacDonaldDepartment of Orthopaedics, University of Edinburgh, Edinburgh, UK.
C R HowieDepartment of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Edinburgh Royal Infirmary · GBUniversity of Edinburgh · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe EuroQol five-dimension (EQ-5D) questionnaire is a widely used multiattribute general health questionnaire where an EQ-5D < 0 defines a state 'worse than death' (WTD). The aim of this study was to determine the proportion of patients awaiting total hip arthroplasty (THA) or total knee arthroplasty (TKA) in a health state WTD and to identify associations with this state. Secondary aims were to examine the effect of WTD status on one-year outcomes. PATIENTS AND

methodsA cross-sectional analysis of 2073 patients undergoing 2073 THAs (mean age 67.4 years (sd 11.6; 14 to 95); mean body mass index (BMI) 28.5 kg/m

resultsPreoperatively, 391 THA patients (19%) and 263 TKA patients (12%) were WTD. Multivariate analysis identified preoperative OHS, deprivation, and chronic obstructive pulmonary disease in THA, and OKS, peripheral arterial disease, and inflammatory arthropathy in TKA as independently associated with WTD status (p < 0.05). One year following arthroplasty EQ-5D scores improved significantly (p < 0.001) and WTD rates reduced to 35 (2%) following THA and 53 (3%) following TKA. Patients who were WTD preoperatively achieved significantly (p < 0.001) worse joint-specific Oxford scores and satisfaction rates one year following joint arthroplasty, compared with those not WTD preoperatively.

conclusionIn total, 19% of patients awaiting THA and 12% awaiting TKA for degenerative joint disease are in a health state WTD. Although specific comorbidities contribute to this, hip- or knee-specific function, mainly pain, appear key determinants and can be reliably reversed with an arthroplasty. Cite this article:

Indexed as

Health Status IndicatorsWaiting ListsAdolescentAdultAgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeCross-Sectional StudiesFemaleHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOsteoarthritis, HipHealth-related quality of lifeHip arthroplastyKnee arthroplasty

Identifiers

PMID31362549
PMCPMC6681678
OpenAlexW2965945945

What Socratic holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.