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The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty.
Knee Surg Sports Traumatol Arthrosc. 2018 Nov; 26(11):3333-3341.KS

Abstract

PURPOSE

The primary aim of this study was to define a classification in the WOMAC score after total knee arthroplasty (TKA) according to patient satisfaction. The secondary aims were to describe patient demographics for each level of satisfaction.

METHODS

A retrospective cohort consisting of 2589 patients undergoing a primary TKA were identified from an established arthroplasty database. Patient demographics, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and short form (SF) 12 scores were collected pre-operatively and 1 year post-operatively. In addition, patient satisfaction was assessed at 1 year with four responses: very satisfied, satisfied, dissatisfied or very dissatisfied. Receiver operating characteristic (ROC) curves were used to identify values in the components and total WOMAC scores that were predictive of each level of satisfaction, which were used to define the categories of excellent, good, fair and poor.

RESULTS

At 1 year, there were 1740 (67.5%) very satisfied, 572 (22.2%) satisfied, 190 (7.4%) dissatisfied and 76 (2.9%) very dissatisfied patients. ROC curve analysis identified excellent, good, fair and poor categories for the pain (> 78, 59-78, 44-58, < 44), function (> 72, 54-72, 41-53, < 41), stiffness (> 69, 56-69, 43-55, < 43) and total (> 75, 56-75, 43-55, < 43) WOMAC scores, respectively. Patients with lung disease, diabetes, gastric ulcer, kidney disease, liver disease, depression, back pain, with worse pre-operative functional scores (WOMAC and SF-12) and those with less of an improvement in the scores, had a significantly lower level of satisfaction.

CONCLUSION

This study has defined a post-operative classification of excellent, good, fair and poor for the components and total WOMAC scores after TKA. The predictors of level of satisfaction should be recognised in clinical practice and patients at risk of a lower level of satisfaction should be made aware in the pre-operative consent process.

LEVEL OF EVIDENCE

III.

Authors+Show Affiliations

Department of Orthopaedics, Newcastle-upon-Tyne University Hospitals Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK. lcwalker86@gmail.com.Department of Orthopaedics, Newcastle-upon-Tyne University Hospitals Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.Department of Orthopaedics, Newcastle-upon-Tyne University Hospitals Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.Department of Orthopaedics, Newcastle-upon-Tyne University Hospitals Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.Department of Orthopaedics, Newcastle-upon-Tyne University Hospitals Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.Department of Orthopaedics, Newcastle-upon-Tyne University Hospitals Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.Department of Orthopaedics, Newcastle-upon-Tyne University Hospitals Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29484445

Citation

Walker, Lucy C., et al. "The WOMAC Score Can Be Reliably Used to Classify Patient Satisfaction After Total Knee Arthroplasty." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 26, no. 11, 2018, pp. 3333-3341.
Walker LC, Clement ND, Bardgett M, et al. The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2018;26(11):3333-3341.
Walker, L. C., Clement, N. D., Bardgett, M., Weir, D., Holland, J., Gerrand, C., & Deehan, D. J. (2018). The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 26(11), 3333-3341. https://doi.org/10.1007/s00167-018-4879-5
Walker LC, et al. The WOMAC Score Can Be Reliably Used to Classify Patient Satisfaction After Total Knee Arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2018;26(11):3333-3341. PubMed PMID: 29484445.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty. AU - Walker,Lucy C, AU - Clement,Nick D, AU - Bardgett,Michelle, AU - Weir,David, AU - Holland,Jim, AU - Gerrand,Craig, AU - Deehan,David J, Y1 - 2018/02/26/ PY - 2017/10/23/received PY - 2018/02/12/accepted PY - 2018/2/28/pubmed PY - 2019/2/16/medline PY - 2018/2/28/entrez KW - Classification KW - Outcome KW - Satisfaction KW - Total knee arthroplasty KW - WOMAC SP - 3333 EP - 3341 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 26 IS - 11 N2 - PURPOSE: The primary aim of this study was to define a classification in the WOMAC score after total knee arthroplasty (TKA) according to patient satisfaction. The secondary aims were to describe patient demographics for each level of satisfaction. METHODS: A retrospective cohort consisting of 2589 patients undergoing a primary TKA were identified from an established arthroplasty database. Patient demographics, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and short form (SF) 12 scores were collected pre-operatively and 1 year post-operatively. In addition, patient satisfaction was assessed at 1 year with four responses: very satisfied, satisfied, dissatisfied or very dissatisfied. Receiver operating characteristic (ROC) curves were used to identify values in the components and total WOMAC scores that were predictive of each level of satisfaction, which were used to define the categories of excellent, good, fair and poor. RESULTS: At 1 year, there were 1740 (67.5%) very satisfied, 572 (22.2%) satisfied, 190 (7.4%) dissatisfied and 76 (2.9%) very dissatisfied patients. ROC curve analysis identified excellent, good, fair and poor categories for the pain (> 78, 59-78, 44-58, < 44), function (> 72, 54-72, 41-53, < 41), stiffness (> 69, 56-69, 43-55, < 43) and total (> 75, 56-75, 43-55, < 43) WOMAC scores, respectively. Patients with lung disease, diabetes, gastric ulcer, kidney disease, liver disease, depression, back pain, with worse pre-operative functional scores (WOMAC and SF-12) and those with less of an improvement in the scores, had a significantly lower level of satisfaction. CONCLUSION: This study has defined a post-operative classification of excellent, good, fair and poor for the components and total WOMAC scores after TKA. The predictors of level of satisfaction should be recognised in clinical practice and patients at risk of a lower level of satisfaction should be made aware in the pre-operative consent process. LEVEL OF EVIDENCE: III. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/29484445/The_WOMAC_score_can_be_reliably_used_to_classify_patient_satisfaction_after_total_knee_arthroplasty_ L2 - https://dx.doi.org/10.1007/s00167-018-4879-5 DB - PRIME DP - Unbound Medicine ER -