Willingness to Have Total Knee Arthroplasty in Rural Areas of Northern China

Objective To evaluate willingness and its potential predictors to have total knee arthroplasty (TKA) among residents in rural areas of northern China. Methods Data were collected from two population‐based studies on osteoarthritis (OA) in northern China. Residents aged ≥ 50 years in randomly selected rural communities were recruited using a cluster survey method. Participants completed a home interview (including social‐demographic characteristics, clinical information, 12‐Item Short Form Health Surveys [SF‐12], and Visual Analog Scale [VAS] of knee pain), a physical examination, and bilateral weight‐bearing posteroanterior semi‐flexed view of radiographs of knees. Willingness to have TKA was queried by asking: “If you need to undergo total knee arthroplasty as judged by orthopaedic surgeons, are you willing to accept this operation?” Two trained investigators read all radiographs independently and reached an acceptable intra‐reader agreement. We fitted univariate and multivariate regressions adjusting for potential confounders to examine predictors of willingness to have TKA stratified by sex. Results A total of 2172 participants were included. The overall rate of willingness to have TKA was 33.8%. Men were more likely to be willing to have TKA than women with an odds ratio (OR) of 0.73 (95% confidence interval [CI]: 0.60–0.89, P = 0.002). A higher household income (OR: 2.34 for men and 1.77 for women, both P