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Early postoperative predictors of satisfaction following total knee arthroplasty.
Knee. 2013 Dec; 20(6):442-6.KNEE

Abstract

BACKGROUND

Despite the excellent total knee arthroplasty (TKA) results reported using traditional outcome measures, dissatisfaction rates of up to 30% are reported following surgery. Although several preoperative factors have been identified as possible predictors of satisfaction, there is conflicting evidence. Identification of dissatisfaction in the early postoperative assessment may therefore be an alternative consideration.

METHODS

We examined the relationship between 12-month satisfaction, and early post-operative outcomes in a cohort of 486 TKA patients. Preoperative, and postoperative outcome measures at 3- and 12-months (Oxford knee score, pain score, SF12, and knee motion), were analysed and compared between patients who were satisfied and dissatisfied at 12-months following TKA. Mean scores, and postoperative change in scores were calculated. Postoperative outcomes were examined for correlation with satisfaction, and multivariate logistic regression models used to identify potential predictors of dissatisfaction.

RESULTS

Overall satisfaction was 77.0%. No preoperative differences were observed between groups. Dissatisfaction was associated with worse postoperative status across all outcome measures (p<0.001), except the 3-month SF12-physical component (p=0.052). Dissatisfied patients demonstrated minimal further improvement or even worsening of outcome scores between 3- and 12-months postoperatively (p<0.02). Both the 3-month OKS (OR=1.15, p<0.001), and knee flexion (OR=1.03, p=0.009) were significant predictors of subsequent 12-month satisfaction.

CONCLUSIONS

Dissatisfaction following TKA is associated with worse outcomes as early as 3months following surgery, with minimal further improvement subsequently achieved at 12-months. Early postoperative assessment following TKA should therefore be considered, including clinical assessment, to identify those patients at risk of dissatisfaction.

Authors+Show Affiliations

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom. Electronic address: derfel.williams@ndorms.ox.ac.uk.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23777807

Citation

Williams, D P., et al. "Early Postoperative Predictors of Satisfaction Following Total Knee Arthroplasty." The Knee, vol. 20, no. 6, 2013, pp. 442-6.
Williams DP, O'Brien S, Doran E, et al. Early postoperative predictors of satisfaction following total knee arthroplasty. Knee. 2013;20(6):442-6.
Williams, D. P., O'Brien, S., Doran, E., Price, A. J., Beard, D. J., Murray, D. W., & Beverland, D. E. (2013). Early postoperative predictors of satisfaction following total knee arthroplasty. The Knee, 20(6), 442-6. https://doi.org/10.1016/j.knee.2013.05.011
Williams DP, et al. Early Postoperative Predictors of Satisfaction Following Total Knee Arthroplasty. Knee. 2013;20(6):442-6. PubMed PMID: 23777807.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early postoperative predictors of satisfaction following total knee arthroplasty. AU - Williams,D P, AU - O'Brien,S, AU - Doran,E, AU - Price,A J, AU - Beard,D J, AU - Murray,D W, AU - Beverland,D E, Y1 - 2013/06/16/ PY - 2012/09/13/received PY - 2013/04/26/revised PY - 2013/05/22/accepted PY - 2013/6/20/entrez PY - 2013/6/20/pubmed PY - 2014/8/13/medline KW - Arthroplasty KW - Knee KW - Outcome KW - PROMs KW - Satisfaction SP - 442 EP - 6 JF - The Knee JO - Knee VL - 20 IS - 6 N2 - BACKGROUND: Despite the excellent total knee arthroplasty (TKA) results reported using traditional outcome measures, dissatisfaction rates of up to 30% are reported following surgery. Although several preoperative factors have been identified as possible predictors of satisfaction, there is conflicting evidence. Identification of dissatisfaction in the early postoperative assessment may therefore be an alternative consideration. METHODS: We examined the relationship between 12-month satisfaction, and early post-operative outcomes in a cohort of 486 TKA patients. Preoperative, and postoperative outcome measures at 3- and 12-months (Oxford knee score, pain score, SF12, and knee motion), were analysed and compared between patients who were satisfied and dissatisfied at 12-months following TKA. Mean scores, and postoperative change in scores were calculated. Postoperative outcomes were examined for correlation with satisfaction, and multivariate logistic regression models used to identify potential predictors of dissatisfaction. RESULTS: Overall satisfaction was 77.0%. No preoperative differences were observed between groups. Dissatisfaction was associated with worse postoperative status across all outcome measures (p<0.001), except the 3-month SF12-physical component (p=0.052). Dissatisfied patients demonstrated minimal further improvement or even worsening of outcome scores between 3- and 12-months postoperatively (p<0.02). Both the 3-month OKS (OR=1.15, p<0.001), and knee flexion (OR=1.03, p=0.009) were significant predictors of subsequent 12-month satisfaction. CONCLUSIONS: Dissatisfaction following TKA is associated with worse outcomes as early as 3months following surgery, with minimal further improvement subsequently achieved at 12-months. Early postoperative assessment following TKA should therefore be considered, including clinical assessment, to identify those patients at risk of dissatisfaction. SN - 1873-5800 UR - https://www.unboundmedicine.com/medline/citation/23777807/Early_postoperative_predictors_of_satisfaction_following_total_knee_arthroplasty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0968-0160(13)00104-X DB - PRIME DP - Unbound Medicine ER -