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Arthritis Rheum. 2004 Aug 15;51(4):635-41.

Perceptions of, and willingness to consider, total joint arthroplasty in a population-based cohort of individuals with disabling hip and knee arthritis.

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University of Toronto, Sunnybrook and Women's College Health Sciences Centre, University Health Network Research Institute, and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.



To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA.


A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects > or =55 years with disabling hip or knee arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire.


Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR] <75 versus > or =75 years 2.42, P = 0.01); worse perceived arthritis severity (OR per unit increase 1.30, P < 0.001); perceiving TJA as appropriate for moderate, controlled joint pain (OR 3.29, P = 0.004); walking limited to <1 block (OR 1.99, P = 0.015); the risk of revision as acceptable (OR 3.73, P < 0.001); and friends as an important health information source (OR 2.49, P = 0.01).


Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.

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