Patient Outcomes After Knee Replacement

Heck, David A.; Robinson, Rebecca; Partridge, Cynthia M.; Lubitz, Robert M.; Freund, Deborah A.

doi:10.1097/00003086-199811000-00015

Cited by 323 publications

(159 citation statements)

References 32 publications

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“…Dissatisfaction ranged from 7.5% to 28.3% (median, 18.6%). Psychological health was deemed a significant predictor in satisfaction at a minimum followup of 6 months after TKA in four studies [18,24,27,44]; another study attributed patient dissatisfaction to postoperative stiffness, but did not comment on the effect of mental health state of patients [28].…”

Section: Resultsmentioning

confidence: 99%

“…The studies were conducted in seven countries: 10 in the USA [3,5,8,9,13,14,24,34,39,46]; four in the UK [27,34,44,50]; four in Canada; [18,26,34,47]; and one each in Australia [34], Spain [15], Greece [37], and Korea [28]. Most studies (17) were conducted in metropolitan populations; one study was a multinational cohort study conducted in 13 centers in four countries (UK, USA, Australia, and Canada) [34].…”

Section: Methodsmentioning

confidence: 99%

“…There was considerable heterogeneity in the self-reported psychological questionnaires used to measure [3,14,15,18,24,26,28,34,44]. Two other studies [8,9] used the State Trait Anxiety Index and the Beck Depression Index.…”

Section: Methodsmentioning

confidence: 99%

“…The Oxford Knee Score was used in three other studies [5,27,44] and the Knee Society Score was used in two studies [8,9]. Patient satisfaction was assessed directly in only five studies [18,24,27,28,44], measured using a four-point Likert scale in three [18,28,44] and a three-point scale in another study [24]. One study used a 100-mm VAS and asked the patients to mark how satisfied they were with the procedure [27].…”

Section: Methodsmentioning

confidence: 99%

“…Despite increasing demand for TKAs and cost-effectiveness of the procedure [11,16,17], a substantial number of patients who undergo a TKA are dissatisfied with the outcomes, with reported satisfaction rates varying between 75% and 89% [1,6,7,23,24,36,41,51], regardless of patient demographics or severity of disease.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Khatib

Madan

Naylor

et al. 2015

Clinical Orthopaedics &Amp; Related Research

149

111

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Background A subgroup of patients undergoing TKA is unhappy with the outcome of surgery and preoperative psychological factors may play a role in their dissatisfaction. Questions/purposes We asked whether (1) psychological factors, as measured by preoperative self-reported questionnaires, predicted poor outcome after TKA, and (2) whether certain psychological factors examined predicted poor outcome better than others. Methods We performed a systematic review and metaanalysis of prospective observational studies published in MEDLINE, CINAHL 1 , EMBASE TM , and PsycINFO 1 databases from their date of inception to October 2013, augmented with a manual search of bibliographies. Study eligibility was performed according to an a priori protocol. Included studies were assessed for quality according to the Newcastle-Ottawa scale. Two reviewers independently performed the search, identified eligible studies, assessed their methodologic quality, and extracted data. Outcomes of interest included postoperative dissatisfaction, pain, or limited function of the patients.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Do Psychological Factors Predict Poor Outcome in Patients Undergoing TKA? A Systematic Review

Khatib

Madan

Naylor

et al. 2015

Clinical Orthopaedics &Amp; Related Research

149

111

View full text Add to dashboard Cite

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Neighborhoods Matter

et al. 2007

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Background: Neighborhood sociodemographic characteristics are associated with health care utilization across many conditions. There has been little study of whether total knee replacement (TKR) recipients from vulnerable populations, including racial and ethnic minorities, the poor, the elderly, and the less well educated, are more likely to use low-volume hospitals (LVHs). Methods: We used Medicare claims and census data to identify a national cohort of Medicare beneficiaries who had elective TKR. We defined an LVH as a center performing fewer than 26 TKRs per year, and we used geocoding to identify "bypassers" (patients who had a highvolume hospital closer to their residence than the one where they had TKR). We used multivariate logistic regression to examine the association of patient and neighborhood characteristics with utilization of LVHs and bypassing. We derived a summative measure of neighborhood vulnerability that included 4 high-risk characteristics (factors were high proportions of residents who are minority individuals, who have foreign-born status, with low income, and with low education). Results: Of 113 015 TKR recipients, 13 120 (11.6%) used LVHs. Of all the TKR recipients, 9815 (8.7%) bypassed a center with a higher TKR volume than the one they used. Multivariate analyses showed that nonwhite (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.16-1.33), poor (OR, 1.94; 95% CI, 1.83-2.08), and nonurban (OR, 1.94; 95% CI, 1.87-2.01) subjects were more likely to use LVHs. The TKR recipients from neighborhoods with 3 or 4 vulnerability factors were more likely than patients in neighborhoods with no vulnerability factors to use an LVH and bypass a high-volume hospital. Conclusion: Efforts to inform patients about the association of volume with TKR outcomes should target rural areas and vulnerable populations in urban settings.

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