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Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age.
Bone Joint J 2016; 98-B(12):1625-1634BJ

Abstract

AIMS

Risk of revision following total knee arthroplasty (TKA) is higher in patients under 55 years, but little data are reported regarding non-revision outcomes. This study aims to identify predictors of dissatisfaction in these patients.

PATIENTS AND METHODS

We prospectively assessed 177 TKAs (157 consecutive patients, 99 women, mean age 50 years; 17 to 54) from 2008 to 2013. Age, gender, implant, indication, body mass index (BMI), social deprivation, range of movement, Kellgren-Lawrence (KL) grade of osteoarthritis (OA) and prior knee surgery were recorded. Pre- and post-operative Oxford Knee Score (OKS) as well as Short Form-12 physical (PCS) and mental component scores were obtained. Post-operative range of movement, complications and satisfaction were measured at one year.

RESULTS

Overall, 44 patients with 44 TKAs (24.9%) under 55 years of age were unsure or dissatisfied with their knee. Significant predictors of dissatisfaction on univariate analysis included: KL grade 1/2 OA (59% dissatisfied), poor pre-operative OKS, complications, poor improvements in PCS and OKS and indication (primary OA 19% dissatisfied, previous meniscectomy 41%, multiply operated 42%, other surgery 29%, BMI > 40 kg/m2 31%, post-traumatic OA 45%, and inflammatory arthropathy 5%). Poor pre-operative OKS, poor improvement in OKS and post-operative stiffness independently predicted dissatisfaction on multivariate analysis.

CONCLUSION

Patients receiving TKA younger than 55 years old should be informed about the increased risks of dissatisfaction. Offering TKA in KL 1/2 is questionable, with a dissatisfaction rate of 59%. Cite this article: Bone Joint J 2016;98-B:1625-34.

Authors+Show Affiliations

Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27909124

Citation

Scott, C E H., et al. "Predicting Dissatisfaction Following Total Knee Arthroplasty in Patients Under 55 Years of Age." The Bone & Joint Journal, vol. 98-B, no. 12, 2016, pp. 1625-1634.
Scott CE, Oliver WM, MacDonald D, et al. Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age. Bone Joint J. 2016;98-B(12):1625-1634.
Scott, C. E., Oliver, W. M., MacDonald, D., Wade, F. A., Moran, M., & Breusch, S. J. (2016). Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age. The Bone & Joint Journal, 98-B(12), pp. 1625-1634.
Scott CE, et al. Predicting Dissatisfaction Following Total Knee Arthroplasty in Patients Under 55 Years of Age. Bone Joint J. 2016;98-B(12):1625-1634. PubMed PMID: 27909124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age. AU - Scott,C E H, AU - Oliver,W M, AU - MacDonald,D, AU - Wade,F A, AU - Moran,M, AU - Breusch,S J, PY - 2016/05/05/received PY - 2016/08/22/accepted PY - 2016/12/3/entrez PY - 2016/12/3/pubmed PY - 2017/2/15/medline KW - Patient reported-outcome measures KW - Patient satisfaction KW - Total knee arthroplasty KW - Young patients SP - 1625 EP - 1634 JF - The bone & joint journal JO - Bone Joint J VL - 98-B IS - 12 N2 - AIMS: Risk of revision following total knee arthroplasty (TKA) is higher in patients under 55 years, but little data are reported regarding non-revision outcomes. This study aims to identify predictors of dissatisfaction in these patients. PATIENTS AND METHODS: We prospectively assessed 177 TKAs (157 consecutive patients, 99 women, mean age 50 years; 17 to 54) from 2008 to 2013. Age, gender, implant, indication, body mass index (BMI), social deprivation, range of movement, Kellgren-Lawrence (KL) grade of osteoarthritis (OA) and prior knee surgery were recorded. Pre- and post-operative Oxford Knee Score (OKS) as well as Short Form-12 physical (PCS) and mental component scores were obtained. Post-operative range of movement, complications and satisfaction were measured at one year. RESULTS: Overall, 44 patients with 44 TKAs (24.9%) under 55 years of age were unsure or dissatisfied with their knee. Significant predictors of dissatisfaction on univariate analysis included: KL grade 1/2 OA (59% dissatisfied), poor pre-operative OKS, complications, poor improvements in PCS and OKS and indication (primary OA 19% dissatisfied, previous meniscectomy 41%, multiply operated 42%, other surgery 29%, BMI > 40 kg/m2 31%, post-traumatic OA 45%, and inflammatory arthropathy 5%). Poor pre-operative OKS, poor improvement in OKS and post-operative stiffness independently predicted dissatisfaction on multivariate analysis. CONCLUSION: Patients receiving TKA younger than 55 years old should be informed about the increased risks of dissatisfaction. Offering TKA in KL 1/2 is questionable, with a dissatisfaction rate of 59%. Cite this article: Bone Joint J 2016;98-B:1625-34. SN - 2049-4408 UR - https://www.unboundmedicine.com/medline/citation/27909124/Predicting_dissatisfaction_following_total_knee_arthroplasty_in_patients_under_55_years_of_age_ L2 - https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.98B12.BJJ-2016-0375.R1?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -