Effects of preoperative walking ability and patient's surgical education on quality of life and functional outcomes after total knee arthroplasty

Abstract

ObjectiveProspectively analyze the effect of preoperative walking status and the patient's surgical education on functional outcomes and the three dimensions of quality of life (QoL) (pain, physical function, and mental health) after elective total knee arthroplasty (TKA).MethodsA comparative analysis on the QoL and functional outcomes in patients who underwent total knee arthroplasty between January 2014 and June 2015. To compare effects of the patient's walking status and knowledge of the surgical procedure on QoL and functional outcomes following TKA by means of SF-36 questionnaire, CES D10, VAS, KSS, KSFS, WOMAC, as well as Friedmann and Wyman scores, 10MWT, and 30-second timed chair test, assessed before the operation and one, three, and six months after the operation.ResultsThere were 168 knees in 154 patients: 46.75% men and 53.24% women. 52.38% of knees had grade-III OA and 40.47% of knees had grade-IV OA. Preoperatively, SF-36 PCS was 33.2 and MCS was 35.4. Mean KSS and KSFS in females was 37.3 (16.2) and 31.5 (13.8); in males it was 49.2 (18.4) and 42.5 (15.7), respectively. Mean WOMAC scores were 64.2 in females and 56.5 in males. Mean VAS and CES D10 scores were 8.8 and 8.2 in females, and 6.9 and 6.4 in males, respectively. Post operatively at the first, third, and sixth month, significant improvements in QoL and mean SF-36, CES D10, VAS, KSS, KSFS, WOMAC, and Friedmann and Wyman scores were observed, as well as in the 10MWT and 30 s timed chair test scores. Patients with better preoperative functional activity and satisfactory understanding of TKA presented a better functional performance and achieved a good quality life (p < 0.01).DiscussionSurgeons educate TKA candidates regarding the surgical procedure, the nature of implants, and how the procedure would affect their lifestyle and what their expectations from TKA should be. These crucial considerations should boost their confidence, enhancing their involvement and cooperation in post-surgical rehabilitation, thereby improving their QoL, functional results, and post TKA experience.ConclusionTKA candidates with good preoperative walking ability and understanding of knee arthroplasty have better QoL in early and late post-surgery periods. Patient's lifestyle and understanding significantly enhances the postoperative functional ability.

Clinical and Functional Outcomes of Primary Total Knee Arthroplasty in the Elderly: A retrospective, Single Center, Real-World Study

“…The heterogeneity of osteoarthritis arises from the many factors that can contribute to cartilage damage [23]. TKA is an e cient surgical intervention for improving mobility and function in elderly patients [24]. In this prospective study, we identi ed signi cant improvement in post-operative functional scores post-surgery in the predominantly elderly cohort of patients [25].…”

The effects of educational intervention on improving the lifestyle of osteoarthritis patients undergoing total knee arthroplasty

“…The most important finding of this study was that training patients regarding lifestyle factors could improve their lifestyle for TKA. 25 Yunis et al also showed a significant relationship between lifestyle modification and educational intervention. 26 In other words, the research hypothesis based on improving patients' lifestyles undergoing TKA followed by training was confirmed.…”

Total Diz Protezi Olan Hastalarda Video-Temelli Eğitim Programının Ağrı, Fiziksel Fonksiyon ve Yaşam Kalitesi Üzerine Etkileri

“…Studies have shown that video-based visits and interviews with healthcare professionals reduce the pain of patients (Jeon & Park, 2016;Louw et al, 2013b).. In studies conducted on this issue, it was determined that the quality of life, physical function, and activities of daily living improved in patients who were trained with written education materials (Dash, Palo, Arora, Chandel, & Kumar, 2017;Demir & Erdil, 2013). However, it was determined that patients who received video-based education had a decrease in pain and a positive effect on quality of life compared with those who received written material education (Demir & Erdil, 2013;Koekenbier et al, 2016).…”