Patients Still Wish for Key Improvements after Total Knee Arthroplasty

Kim, Seok Jin; Bamne, Ankur B.; Song, Young Dong; Kang, Yeon June; Kim, Tae Kyun

doi:10.5792/ksrr.2015.27.1.24

Cited by 29 publications

(17 citation statements)

References 28 publications

(47 reference statements)

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“…Baker et al 10) reviewed the data from the National Joint Registry for England and Wales: 71% of the patients perceived improvement of knee symptoms, but only 22% rated the results as 'excellent'. Kim et al 11) reported that in spite of the clear evidence of improvement after TKA in terms of restoration of daily living activities and pain relief, patient satisfaction level was moderate.…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction after Total Knee Arthroplasty

Choi

Jong

2016

Knee Surg Relat Res

321

184

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Total knee arthroplasty (TKA) is one of the most successful and effective surgical options to reduce pain and restore function for patients with severe osteoarthritis. The purpose of this article was to review and summarize the recent literatures regarding patient satisfaction after TKA and to analyze the various factors associated with patient dissatisfaction after TKA. Patient satisfaction is one of the many patient-reported outcome measures (PROMs). Patient satisfaction can be evaluated from two categories, determinants of satisfaction and components of satisfaction. The former have been described as all of the patient-related factors including age, gender, personality, patient expectations, medical and psychiatric comorbidity, patient's diagnosis leading to TKA and severity of arthropathy. The latter are all of the processes and technical aspects of TKA, ranging from the anesthetic and surgical factors, type of implants and postoperative rehabilitations. The surgeon- and patient-reported outcomes have been shown to be disparate occasionally. Among various factors that contribute to patient satisfaction, some factors can be managed by the surgeon, which should be improved through continuous research. Furthermore, extensive discussion and explanation before surgery will reduce patient dissatisfaction after TKA.

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Section: Introductionmentioning

confidence: 99%

Patient Satisfaction after Total Knee Arthroplasty

Choi

Jong

2016

Knee Surg Relat Res

321

184

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“…[ 10 ] The time course for the decrease and recovery of quadriceps muscle strength from before to after surgery may help in planning rehabilitation schedules for patients who undergo TKA, [ 11 ] because rapid recovery to an adequate level of quadriceps strength is key to functional performance. [ 4 , 12 ] Most previous studies, however, have evaluated postoperative quadriceps strength on the TKA side relative to the uninvolved side at a single time point, such as 3, 6, or 12 months after surgery. [ 7 , 11 , 13 ] In addition, few studies have evaluated the time course of recovery of hamstring muscle strength.…”

Section: Introductionmentioning

confidence: 99%

Serial Changes of Quadriceps and Hamstring Muscle Strength Following Total Knee Arthroplasty: A Meta-Analysis

et al. 2016

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This meta-analysis was performed to analyze serial changes in thigh muscles, including quadriceps and hamstring muscles, from before to one year after total knee arthroplasty (TKA). All studies sequentially comparing isokinetic quadriceps and hamstring muscle strengths between the TKA side and the contralateral uninjured limb were included in this meta-analysis. Five studies with 7 cohorts were included in this meta-analysis. The mean differences in the strengths of quadriceps and hamstring muscles between the TKA and uninjured sides were greatest three months after surgery (26.8 N∙m, 12.8 N∙m, P<0.001), but were similar to preoperative level at six months (18.4 N∙m, 7.4 N∙m P<0.001) and were maintained for up to one year (15.9 N∙m, 4.1 N∙m P<0.001). The pooled mean differences in changes in quadriceps and hamstring strengths relative to preoperative levels were 9.2 N∙m and 4.9 N∙m, respectively, three months postoperatively (P = 0.041), but were no longer significant after six months and one year. During the year after TKA, quadriceps and hamstring muscle strengths were lowest after 3 months, recovering to preoperative level after six months, but not reaching the muscle strength on the contralateral side. Relative to preoperative levels, the difference in muscle strength between the TKA and contralateral knees was only significant at three months. Because decrease of strength of the quadriceps was significantly greater than decrease in hamstring muscle strength at postoperative three months, early rehabilitation after TKA should focus on recovery of quadriceps muscle strength.

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“…Despite the generally successful results of contemporary TKAs, many patients remain dissatisfied with the performance of their replaced knees [1,8,20]. The frustration may be even more pronounced among Asian patients, as their functional demands related to a floor-based lifestyle are generally greater than Western patients [7]. Furthermore, if Asian patients have certain demographic and anatomical characteristics known to affect clinical outcomes, special strategies to accom modate the unique nature of Asian patients may be required for preoperative patient counseling, prosthesis design, surgical technique, and postoperative rehabilitation.…”

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confidence: 99%