Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 1/2013

01.01.2013 | Symposium: Papers Presented at the Annual Meetings of the Knee Society

Postoperative Alignment and ROM Affect Patient Satisfaction After TKA

verfasst von: Shuichi Matsuda, MD, Shinya Kawahara, MD, Ken Okazaki, MD, Yasutaka Tashiro, MD, Yukihide Iwamoto, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Patient satisfaction has increasingly been recognized as an important measure after total knee arthroplasty (TKA). However, we do not know yet how and why the patients are satisfied or dissatisfied with TKA.

Questions/purposes

We asked: (1) After TKA, how satisfied are patients and which activities were they able to do? (2) Are patient-derived scores related to physician-derived scores? (3) Which factors affect patient satisfaction and function?

Methods

We retrospectively evaluated 375 patients who had undergone 500 TKAs between February 22, 2000 and December 1, 2009. We sent a questionnaire for The 2011 Knee Society Knee Scoring System to the patients. We determined the correlation of patient- and physician-derived scores and factors relating to the five questions relating to satisfaction and the 19 questions relating function. The minimum followup was 2 years (mean, 5 years; range, 2–11 years).

Results

The mean score for symptoms was 19 (74%), 23 (59%) for patient satisfaction, 10 (64%) for patient expectations, and 53 (53%) for functional activities. We found a poor correlation between the patient-derived and the physician-derived scores. Old age and varus postoperative alignment negatively correlated with the satisfaction. Varus alignment and limited range of motion (ROM) negatively correlated with the expectation. Old age, rheumatoid arthritis, and limited ROM negatively correlated with the functional activities.

Conclusions

Most patients did not report symptoms, but they experienced difficulty with activities of daily living after TKA. Patient satisfaction is difficult to measure, but avoiding varus alignment and achieving better ROM appear to be important for increasing satisfaction and meeting expectations.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Baumann C, Rat AC, Mainard D, Cuny C, Guillemin F. Importance of patient satisfaction with care in predicting osteoarthritis-specific health-related quality of life one year after total joint arthroplasty. Qual Life Res. 2011;20:1581–1588.PubMedCrossRef Baumann C, Rat AC, Mainard D, Cuny C, Guillemin F. Importance of patient satisfaction with care in predicting osteoarthritis-specific health-related quality of life one year after total joint arthroplasty. Qual Life Res. 2011;20:1581–1588.PubMedCrossRef
2.
Zurück zum Zitat Becker R, Doring C, Denecke A, Brosz M. Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011;19:1433–1441.PubMedCrossRef Becker R, Doring C, Denecke A, Brosz M. Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011;19:1433–1441.PubMedCrossRef
3.
Zurück zum Zitat Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed
4.
Zurück zum Zitat Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Comparing patient outcomes after THA and TKA: is there a difference? Clin Orthop Relat Res. 2010;468:542–546.PubMedCrossRef Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Comparing patient outcomes after THA and TKA: is there a difference? Clin Orthop Relat Res. 2010;468:542–546.PubMedCrossRef
5.
Zurück zum Zitat Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468:57–63.PubMedCrossRef Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468:57–63.PubMedCrossRef
6.
Zurück zum Zitat Bullens PH, van Loon CJ, de Waal Malefijt MC, Laan RF, Veth RP. Patient satisfaction after total knee arthroplasty: a comparison between subjective and objective outcome assessments. J Arthroplasty. 2001;16:740–747. Bullens PH, van Loon CJ, de Waal Malefijt MC, Laan RF, Veth RP. Patient satisfaction after total knee arthroplasty: a comparison between subjective and objective outcome assessments. J Arthroplasty. 2001;16:740–747.
7.
Zurück zum Zitat Callaghan JJ, O’Rourke M R, Saleh KJ. Why knees fail: lessons learned. J Arthroplasty. 2004;19:31–34.PubMedCrossRef Callaghan JJ, O’Rourke M R, Saleh KJ. Why knees fail: lessons learned. J Arthroplasty. 2004;19:31–34.PubMedCrossRef
8.
Zurück zum Zitat Cohen SB, Strand V, Aguilar D, Ofman JJ. Patient- versus physician-reported outcomes in rheumatoid arthritis patients treated with recombinant interleukin-1 receptor antagonist (anakinra) therapy. Rheumatology (Oxford). 2004;43:704–711.CrossRef Cohen SB, Strand V, Aguilar D, Ofman JJ. Patient- versus physician-reported outcomes in rheumatoid arthritis patients treated with recombinant interleukin-1 receptor antagonist (anakinra) therapy. Rheumatology (Oxford). 2004;43:704–711.CrossRef
9.
Zurück zum Zitat Culliton SE, Bryant DM, Overend TJ, Macdonald SJ, Chesworth BM. The relationship between expectations and satisfaction in patients undergoing primary total knee arthroplasty. J Arthroplasty. 2012;27:490–492.PubMedCrossRef Culliton SE, Bryant DM, Overend TJ, Macdonald SJ, Chesworth BM. The relationship between expectations and satisfaction in patients undergoing primary total knee arthroplasty. J Arthroplasty. 2012;27:490–492.PubMedCrossRef
10.
Zurück zum Zitat Dahm DL, Barnes SA, Harrington JR, Sayeed SA, Berry DJ. Patient-reported activity level after total knee arthroplasty. J Arthroplasty. 2008;23:401–407.PubMedCrossRef Dahm DL, Barnes SA, Harrington JR, Sayeed SA, Berry DJ. Patient-reported activity level after total knee arthroplasty. J Arthroplasty. 2008;23:401–407.PubMedCrossRef
11.
Zurück zum Zitat Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998;80:63–69.PubMedCrossRef Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998;80:63–69.PubMedCrossRef
12.
Zurück zum Zitat Devers BN, Conditt MA, Jamieson ML, Driscoll MD, Noble PC, Parsley BS. Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty? J Arthroplasty. 2011;26:178–186.PubMedCrossRef Devers BN, Conditt MA, Jamieson ML, Driscoll MD, Noble PC, Parsley BS. Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty? J Arthroplasty. 2011;26:178–186.PubMedCrossRef
13.
Zurück zum Zitat Fitzgerald SJ, Trousdale RT. Why knees fail in 2011: patient, surgeon, or device? Orthopedics. 2011;34:e513–e515.PubMed Fitzgerald SJ, Trousdale RT. Why knees fail in 2011: patient, surgeon, or device? Orthopedics. 2011;34:e513–e515.PubMed
14.
Zurück zum Zitat Gandhi R, Davey JR, Mahomed N. Patient expectations predict greater pain relief with joint arthroplasty. J Arthroplasty. 2009;24:716–721.PubMedCrossRef Gandhi R, Davey JR, Mahomed N. Patient expectations predict greater pain relief with joint arthroplasty. J Arthroplasty. 2009;24:716–721.PubMedCrossRef
15.
Zurück zum Zitat Gandhi R, de Beer J, Petruccelli D, Winemaker M. Does patient perception of alignment affect total knee arthroplasty outcome? Can J Surg. 2007;50:181–186.PubMed Gandhi R, de Beer J, Petruccelli D, Winemaker M. Does patient perception of alignment affect total knee arthroplasty outcome? Can J Surg. 2007;50:181–186.PubMed
16.
Zurück zum Zitat Ghanem E, Pawasarat I, Lindsay A, May L, Azzam K, Joshi A, Parvizi J. Limitations of the Knee Society Score in evaluating outcomes following revision total knee arthroplasty. J Bone Joint Surg Am. 2010;92:2445–2451.PubMedCrossRef Ghanem E, Pawasarat I, Lindsay A, May L, Azzam K, Joshi A, Parvizi J. Limitations of the Knee Society Score in evaluating outcomes following revision total knee arthroplasty. J Bone Joint Surg Am. 2010;92:2445–2451.PubMedCrossRef
17.
Zurück zum Zitat Gioe TJ, Pomeroy D, Suthers K, Singh JA. Can patients help with long-term total knee arthroplasty surveillance? Comparison of the American Knee Society Score self-report and surgeon assessment. Rheumatology (Oxford). 2009;48:160–164.CrossRef Gioe TJ, Pomeroy D, Suthers K, Singh JA. Can patients help with long-term total knee arthroplasty surveillance? Comparison of the American Knee Society Score self-report and surgeon assessment. Rheumatology (Oxford). 2009;48:160–164.CrossRef
18.
Zurück zum Zitat Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–14.PubMed Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–14.PubMed
19.
Zurück zum Zitat Khanna G, Singh JA, Pomeroy DL, Gioe TJ. Comparison of patient-reported and clinician-assessed outcomes following total knee arthroplasty. J Bone Joint Surg Am. 2011;93:e117.1–e117.7.CrossRef Khanna G, Singh JA, Pomeroy DL, Gioe TJ. Comparison of patient-reported and clinician-assessed outcomes following total knee arthroplasty. J Bone Joint Surg Am. 2011;93:e117.1–e117.7.CrossRef
20.
Zurück zum Zitat Kwon SK, Kang YG, Kim SJ, Chang CB, Seong SC, Kim TK. Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty. J Arthroplasty. 2010;25:1125–1130.PubMedCrossRef Kwon SK, Kang YG, Kim SJ, Chang CB, Seong SC, Kim TK. Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty. J Arthroplasty. 2010;25:1125–1130.PubMedCrossRef
21.
Zurück zum Zitat Liow RY, Walker K, Wajid MA, Bedi G, Lennox CM. The reliability of the American Knee Society Score. Acta Orthop Scand. 2000;71:603–608.PubMedCrossRef Liow RY, Walker K, Wajid MA, Bedi G, Lennox CM. The reliability of the American Knee Society Score. Acta Orthop Scand. 2000;71:603–608.PubMedCrossRef
22.
Zurück zum Zitat Lopez-Olivo MA, Landon GC, Siff SJ, Edelstein D, Pak C, Kallen MA, Stanley M, Zhang H, Robinson KC, Suarez-Almazor ME. Psychosocial determinants of outcomes in knee replacement. Ann Rheum Dis. 2011;70:1775–1781.PubMedCrossRef Lopez-Olivo MA, Landon GC, Siff SJ, Edelstein D, Pak C, Kallen MA, Stanley M, Zhang H, Robinson KC, Suarez-Almazor ME. Psychosocial determinants of outcomes in knee replacement. Ann Rheum Dis. 2011;70:1775–1781.PubMedCrossRef
23.
Zurück zum Zitat Mahomed N, Gandhi R, Daltroy L, Katz JN. The self-administered patient satisfaction scale for primary hip and knee arthroplasty. Arthritis. 2011;2011:591253.PubMedCrossRef Mahomed N, Gandhi R, Daltroy L, Katz JN. The self-administered patient satisfaction scale for primary hip and knee arthroplasty. Arthritis. 2011;2011:591253.PubMedCrossRef
24.
Zurück zum Zitat Marx RG, Jones EC, Atwan NC, Closkey RF, Salvati EA, Sculco TP. Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome. J Bone Joint Surg Am. 2005;87:1999–2005.PubMedCrossRef Marx RG, Jones EC, Atwan NC, Closkey RF, Salvati EA, Sculco TP. Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome. J Bone Joint Surg Am. 2005;87:1999–2005.PubMedCrossRef
25.
Zurück zum Zitat Mizner RL, Petterson SC, Clements KE, Zeni JA Jr, Irrgang JJ, Snyder-Mackler L. Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplasty. 2011;26:728–737.PubMedCrossRef Mizner RL, Petterson SC, Clements KE, Zeni JA Jr, Irrgang JJ, Snyder-Mackler L. Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplasty. 2011;26:728–737.PubMedCrossRef
26.
Zurück zum Zitat Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006;452:35–43.PubMedCrossRef Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006;452:35–43.PubMedCrossRef
27.
Zurück zum Zitat Noble PC, Scuderi GR, Brekke AC, Sikorskii A, Benjamin JB, Lonner JH, Chadha P, Daylamani DA, Scott WN, Bourne RB. Development of a new Knee Society scoring system. Clin Orthop Relat Res. 2012;470:20–32.PubMedCrossRef Noble PC, Scuderi GR, Brekke AC, Sikorskii A, Benjamin JB, Lonner JH, Chadha P, Daylamani DA, Scott WN, Bourne RB. Development of a new Knee Society scoring system. Clin Orthop Relat Res. 2012;470:20–32.PubMedCrossRef
28.
Zurück zum Zitat Padua R, Ceccarelli E, Bondi R, Campi A, Padua L. Range of motion correlates with patient perception of TKA outcome. Clin Orthop Relat Res. 2007;460:174–177.PubMed Padua R, Ceccarelli E, Bondi R, Campi A, Padua L. Range of motion correlates with patient perception of TKA outcome. Clin Orthop Relat Res. 2007;460:174–177.PubMed
29.
Zurück zum Zitat Scott CE, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br. 2010;92:1253–1258.PubMedCrossRef Scott CE, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br. 2010;92:1253–1258.PubMedCrossRef
30.
Zurück zum Zitat Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new Knee Society knee scoring system. Clin Orthop Relat Res. 2012;470:3–19.PubMedCrossRef Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new Knee Society knee scoring system. Clin Orthop Relat Res. 2012;470:3–19.PubMedCrossRef
31.
Zurück zum Zitat Sullivan M, Tanzer M, Reardon G, Amirault D, Dunbar M, Stanish W. The role of presurgical expectancies in predicting pain and function one year following total knee arthroplasty. Pain. 2011;152:2287–2293.PubMedCrossRef Sullivan M, Tanzer M, Reardon G, Amirault D, Dunbar M, Stanish W. The role of presurgical expectancies in predicting pain and function one year following total knee arthroplasty. Pain. 2011;152:2287–2293.PubMedCrossRef
32.
Zurück zum Zitat Tugwell P, Bombardier C, Buchanan WW, Goldsmith CH, Grace E, Hanna B. The MACTAR Patient Preference Disability Questionnaire—an individualized functional priority approach for assessing improvement in physical disability in clinical trials in rheumatoid arthritis. J Rheumatol. 1987;14:446–451.PubMed Tugwell P, Bombardier C, Buchanan WW, Goldsmith CH, Grace E, Hanna B. The MACTAR Patient Preference Disability Questionnaire—an individualized functional priority approach for assessing improvement in physical disability in clinical trials in rheumatoid arthritis. J Rheumatol. 1987;14:446–451.PubMed
33.
Zurück zum Zitat Ware JE Jr, Sherbourne CD. The MOS 36-item Short-Form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRef Ware JE Jr, Sherbourne CD. The MOS 36-item Short-Form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRef
34.
Zurück zum Zitat Wylde V, Blom AW, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC. Patient-reported outcomes after total hip and knee arthroplasty: comparison of midterm results. J Arthroplasty. 2009;24:210–216.PubMedCrossRef Wylde V, Blom AW, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC. Patient-reported outcomes after total hip and knee arthroplasty: comparison of midterm results. J Arthroplasty. 2009;24:210–216.PubMedCrossRef
35.
Zurück zum Zitat Zisapel N, Nir T. Determination of the minimal clinically significant difference on a patient visual analog sleep quality scale. J Sleep Res. 2003;12:291–298.PubMedCrossRef Zisapel N, Nir T. Determination of the minimal clinically significant difference on a patient visual analog sleep quality scale. J Sleep Res. 2003;12:291–298.PubMedCrossRef
Metadaten
Titel
Postoperative Alignment and ROM Affect Patient Satisfaction After TKA
verfasst von
Shuichi Matsuda, MD
Shinya Kawahara, MD
Ken Okazaki, MD
Yasutaka Tashiro, MD
Yukihide Iwamoto, MD
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 1/2013
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2533-y

Weitere Artikel der Ausgabe 1/2013

Clinical Orthopaedics and Related Research® 1/2013 Zur Ausgabe

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Which Factors Increase Risk of Malalignment of the Hip-Knee-Ankle Axis in TKA?

Symposium: Papers Presented at the Annual Meetings of the Knee Society

High Infection Control Rate and Function After Routine One-stage Exchange for Chronically Infected TKA

Symposium: Papers Presented at the Annual Meetings of the Knee Society

Failure of Irrigation and Débridement for Early Postoperative Periprosthetic Infection

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.