Skip Navigation



Family Practice Advance Access published online on November 1, 2004
Family Practice, doi:10.1093/fampra/cmh609
© 2004 by Oxford University Press
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/1/118    most recent
cmh609v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Linsell, L.
Right arrow Articles by Fitzpatrick, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Linsell, L.
Right arrow Articles by Fitzpatrick, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Article

Prospective study of elderly people comparing treatments following first primary care consultation for a symptomatic hip or knee

Louise Linsell 1, Jill Dawson 2*, Krina Zondervan 3, Tony Randall 1, Peter Rose 1, Andrew Carr 4, and Ray Fitzpatrick 1

1 Division of Public Health and Primary Health Care, Old Road, Oxford OX3 7LF, UK
2 School of Health and Social Care, Oxford Brookes University, Marston Road Campus, Jack Straws Lane, Oxford OX3 OFL, UK
3 Wellcome Trust Centre for Human Genetics, University of Oxford, Windmill Road, Oxford OX3 7LD, UK
4 Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK

* To whom correspondence should be addressed.
Jill Dawson, E-mail: jdawson{at}brookes.ac.uk


  Abstract

Background. Symptomatic knee problems in elderly people are considerably more common than hip problems, yet far more hips are replaced.

Objective. The purpose of this study was to investigate whether systematic differences occur in early primary care management of elderly patients who first consult with hip versus knee symptoms.

Methods. A prospective analysis was carried out of anonymized records in the MediPlus general practice database. This was a 3 year (1996-1998) prospective study of 310 843 patients aged 65+ regarding consultations about a new hip or knee problem. Survival analysis techniques were used to analyse time to and frequency of various interventions.

Results. A total of 1410 new hip and 3152 new knee consulters were identified. Baseline characteristics of the two groups were very similar. By 3 years following the first consultation, more of the hip cases had referral to a specialist (38.2% hips versus 31.5% knees, P < 0.001) and joint replacement (9.6% hips versus 1.8% knees, P < 0.001) recorded. Non-steroidal antiinflammatory drug (NSAID) prescribing was high for both groups, with ~51% prescribed one of the safer forms and ~15% prescribed one with a lower safety record within 3 years.

Conclusion. Rates of specialist referral and joint replacement in older people are much lower, or slower, for those with symptomatic knees relative to hips. In the absence of surgery, prescriptions for pain killers are similar for both groups. Elderly people with symptomatic knees are therefore at increased risk of drug side effects relative to those with symptomatic hips. This may represent another facet of unmet need for surgery in people with knee disease.

Keywords: Hip pain; knee pain; NSAIDs; primary care.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Rheumatology (Oxford)Home page
M. Porcheret, K. Jordan, C. Jinks, and P. Croft in collaboration with the Primary Care Rh
Primary care treatment of knee pain a survey in older adults
Rheumatology, November 1, 2007; 46(11): 1694 - 1700.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.