Patient satisfaction after total knee arthroplasty

Purposes The focus in the evaluation of total knee arthroplasty has shifted from objective measures of implant position and knee function, to patient-reported outcome measures (PROMs). The relation between these two measures was investigated and the possibility of prediction of the patient satisfaction level was evaluated by defining thresholds for improvement of (1) range of motion (ROM), (2) 6-min walk test (6MWT), (3) sit-to-stand test (STS) and (4) quadriceps force after TKA? Methods Fifty-seven patients were prospectively tested at preoperative and 6 months postoperative intervals. The ROM, 6MWT, STS-test and quadriceps force were evaluated. Two clusters were created based on the postoperative KOOS, OKS and the satisfaction subscore of the new KSS, cluster 1 consisted of patients with good to excellent PROMs, cluster 2 of patients with poorer PROMs. Patients in each cluster were more similar to each other than to those in the other cluster. Receiver operating characteristic (ROC)-curve analysis was used to identify thresholds for the functional outcomes that established cluster allocation. Multiple logistic regression was used to define a model to predict cluster allocation. Results Patients with high postoperative PROMs (cluster 1 allocation) showed higher postoperative functional outcomes (p < 0.05). Thresholds for the improvement of ROM (≥ 5°, OR 6.3, 95% CI 1.23-31.84), 6MWT (≥ 50 m, OR 8.2, 95% CI 1.61-42.18) STS (≥ 1.05 s, OR 3, 95% CI 0.56-16.07) and normalized Q4 force (≥ 1.5 N/BMI, OR 2.5, 95% CI 0.49-12.89) were found to be predictors of cluster allocation. A model to predict the cluster allocation contained gender, ROM improvement and 6MWT improvement (sensitivity 91.1%, specificity 75%). Conclusions Thresholds for improvement of functional parameters can predict the patient satisfaction cluster. Patients, who are male, improve on the 6-min walk test with 50 m or more and have an increased range of motion of 5° or more, compared to the preoperative situation, are 6-8 times more likely of being satisfied after TKA. These tests are easy to use in clinical practice and can predict the level of patient satisfaction after TKA. Level of evidence Level II, prognostic study.

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“…The procedure for the 6MWT was based on published guidelines [6]. A 40-m long section of the hallway was demarcated for this test.…”

Section: Variables and Outcome Measuresmentioning

confidence: 99%

Improved walking distance and range of motion predict patient satisfaction after TKA

Onsem

Verstraete

Dhont

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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“…Registry data show excellent implant survival with ten-year revision rates around 5 %. However, there is a well-known difference between patients' satisfaction and measured clinical outcome in TKA [2][3][4][5][6]. Recent studies have demonstrated that, contrary to hip arthroplasty patients, up to 25 % of the TKA patients are dissatisfied with the implanted total knee [1,[7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Pre-operative arthritis severity as a predictor for total knee arthroplasty patients’ satisfaction

Schnurr

Jarrous

Güdden

et al. 2013

International Orthopaedics (SICOT)

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Purpose Studies have shown that up to 25 % of TKA patients are dissatisfied with the implanted knee, even if registry data shows ten-year revision rates below 5 %. It has been the question of our study, if it would be possible to identify those patients at risk for dissatisfaction pre-operatively. Methods The data of 1,121 consecutive TKA patients with a follow-up between one and six years have been analysed retrospectively. Demographic, radiologic and perioperative variables have been recorded and all patients were asked by questionnaire for satisfaction with the implanted knee. Logistic regression models have been used to identify significant risk factors. Results The data of 996 patients (89 %) were complete, 849 (85.2 %) reported satisfaction and 147 (14.8 %) dissatisfaction. Patients' satisfaction was independent of the time after operation (p=0.285). The only factor which influenced patients' satisfaction was the osteoarthritic severity. In comparison to severe arthritis Kellgren Lawrence IV°, the risk for dissatisfaction was 2.556-fold elevated for arthritis grade III°(p<0.001) and 2.956-fold higher for grade II°(p=0.001). Conclusions Patients suffering from mild or moderate osteoarthritis are at risk for dissatisfaction after TKA. The TKA indication in those patients should therefore be critically proven. Furthermore, to adjust patients' expectations, the elevated dissatisfaction risk in case of mild or moderate osteoarthritis should be included into patients' pre-operative information.

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“…Estas encuestas, por lo general, evalúan funciones físicas, como movilidad, cuidado de sí mismo y bienestar psicológico, y aspectos subjetivos, como dolor, cansancio, y actividad social, laboral, doméstica y recreativa. 3,4,6,8,11,16 Evaluando y amalgamando en conjunto estos ítems, puede obtenerse la eficacia global o outcomes de una artroplastia. Para lograrlo, parecería inevitable analizar cuidadosamente la situación preoperatoria y luego compararla con la posoperatoria en busca de estos resultados.…”

Section: Discussionunclassified

“…6 y Bullens y cols. 16 informaron similares resultados; el dolor durante la actividad habitual fue el factor más determinante del bienestar luego de un RTC y de rodilla respectivamente.…”

Section: Discussionunclassified

Satisfacción del paciente luego de una artroplastia de cadera o rodilla

Lopreite¹,

Garabano²,

Pastrián³

et al. 2012

Rev. Asoc. Arg. Ort. y Traumatol

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RESUMEN Introducción:Desde hace tiempo se ha comenzado a prestar atención a la satisfacción del paciente luego de una artroplastia de cadera o de rodilla. Con ese propósito se han confeccionado diferentes sistemas de encuestas para medir los efectos de la cirugía en la vida del paciente. El objetivo de este trabajo fue evaluar, mediante una encuesta, la satisfacción luego de un reemplazo total de rodilla o de cadera. Materiales y métodos: Se analizaron 59 reemplazos totales de cadera primarios en 59 pacientes con un promedio de edad de 64,4 años y un seguimiento promedio de 3,4 años, y 47 reemplazos totales de rodilla unilaterales en pacientes con un promedio de edad de 62,2 años y un seguimiento promedio de 3,2 años. A todos se les entregó una encuesta para completar en el hogar. Estos pacientes tenían, como mínimo, un año de seguimiento. Resultados: Los pacientes que recibieron un reemplazo total de cadera estuvieron conformes en un 98,3%, mientras que los tratados con reemplazo total de rodilla lo estuvieron en un 100%. En cuanto al cumplimiento de las expectativas, el 95% de los que recibieron un reemplazo total de cadera estuvieron absolutamente conformes y los tratados con reemplazo total de rodillalo estuvieron en el 86,6%. El puntaje promedio de la encuesta para los primeros fue de 6,2 y para los segundos, de 12. Conclusiones: Entre el 81% y el 89% de los pacientes están conformes luego de un reemplazo total de cadera, mientras que entre el 83% y el 96% lo estará luego de un reemplazo total de rodilla. Las expectativas antes de una artroplastia se centran en el alivio del dolor, la mejoría funcional y la independencia física. Si bien enesta serie se encontraron niveles aceptables de satisfacción, el cirujano debe ser prudente en el preoperatorio para no crear falsas expectativas en cuanto a los resultados y mejorar así la satisfacción de los pacientes después de la intervención.PALABRAS CLAVE: Artroplastia total de cadera. Artroplastia total de rodilla. Satisfacción. Expectativas. ABSTRACT Background: Has long time, started to pay attention to the patients satisfaction after a total hip or knee arthroplasty. Different systems of surveys to measure the surgery impact on the patient's life have been drawn up for this. The objective of this work was through a survey to assess patient satisfaction after a TKA or THA. Methods: We analyze 59 primary THA in 59 patients with average age of 64.4 years and rate follow up of 3,4 years. And 47 unilateral TKH, with an average of 62,2 years and follow up of 3.2 years. All were given a survey to ensure that they complete in their homes. At least these patients had one year of follow-up. Results: The THA results were consistent with the surgery in a 98.3%, while the TKA were in100%. With regard to the fulfilment of expectations 95% of the THA were absolutely consistent and the TKA were 86.6%. The average score in the survey for the RTC was 6.2 points and for the RTR was 12 points. Conclusions: Among the 81% and 89% of the patients are happy then an THA, while between 83...

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Patient satisfaction after total knee arthroplasty

Cited by 326 publications

References 20 publications

Improved walking distance and range of motion predict patient satisfaction after TKA

Improved walking distance and range of motion predict patient satisfaction after TKA

Pre-operative arthritis severity as a predictor for total knee arthroplasty patients’ satisfaction

Satisfacción del paciente luego de una artroplastia de cadera o rodilla

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