Patients Still Wish for Key Improvements after Total Knee Arthroplasty
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: Our goals were to rigorously document and explore the interrelationships of various parameters in the aftermath of total knee arthroplasty (TKA), including patient characteristics, clinical scores, satisfaction levels, and patient-perceived improvements. Materials and Methods: A questionnaire addressing sociodemographic factors, levels of satisfaction, and “wished-for” improvements was administered to 180 patients at least 1 year post primary TKA. Both satisfaction levels and wished-for improvements were assessed through nine paired parameters. Patients responded using an 11-point visual analogue scale (VAS) and the results were summarized as mean VAS score. Correlations between clinical scores and satisfaction levels and between satisfaction levels and desired improvements were analyzed. Results: Patient satisfaction levels were only modest (mean score, 4–7) for eight of the nine parameters, including pain relief and restoration of daily living activities, the top two ranked parameters in wished-for improvement while high-flexion activity constituted the top source of discontent. Wished-for improvement was high in seven parameters, the top three being restoration of daily living activities, pain relief, and high-flexion activity. The effects of sociodemographic factors on satisfaction levels and wished-for improvement varied. Satisfaction levels correlated positively with functional outcomes, and satisfaction in pain relief and restoration of daily living activities correlated more often and most strongly with clinical scores. Conclusions: Following TKA, patient satisfaction is not high for a number of issues, with improvements clearly needed in restoring daily living activities and relieving pain. Continued efforts to achieve better surgical outcomes should address patient-perceived shortcomings.
Abstract
Purpose: Our goals were to rigorously document and explore the interrelationships of various parameters in the aftermath of total knee arthroplasty (TKA), including patient characteristics, clinical scores, satisfaction levels, and patient-perceived improvements. Materials and Methods: A questionnaire addressing sociodemographic factors, levels of satisfaction, and “wished-for” improvements was administered to 180 patients at least 1 year post primary TKA. Both satisfaction levels and wished-for improvements were assessed through nine paired parameters. Patients responded using an 11-point visual analogue scale (VAS) and the results were summarized as mean VAS score. Correlations between clinical scores and satisfaction levels and between satisfaction levels and desired improvements were analyzed. Results: Patient satisfaction levels were only modest (mean score, 4–7) for eight of the nine parameters, including pain relief and restoration of daily living activities, the top two ranked parameters in wished-for improvement while high-flexion activity constituted the top source of discontent. Wished-for improvement was high in seven parameters, the top three being restoration of daily living activities, pain relief, and high-flexion activity. The effects of sociodemographic factors on satisfaction levels and wished-for improvement varied. Satisfaction levels correlated positively with functional outcomes, and satisfaction in pain relief and restoration of daily living activities correlated more often and most strongly with clinical scores. Conclusions: Following TKA, patient satisfaction is not high for a number of issues, with improvements clearly needed in restoring daily living activities and relieving pain. Continued efforts to achieve better surgical outcomes should address patient-perceived shortcomings.
참고문헌 (31)
- Jones CA, "Total joint arthroplasties : current concepts of patient outcomes after surgery", Rheum Dis Clin North Am, 33, pp.71~86 (2007)
- Kim TK, "Functional disabilities and satisfaction after total knee arthroplasty in female Asian patients", J Arthroplasty, 25, pp.458~464 (2010)
- Bourne RB, "Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?", Clin Orthop Relat Res, 468, pp.57~63 (2010)
- Wylde V, "Total knee replacement: is it really an effective procedure for all?", Knee, 14, pp.417~423 (2007)
- Gandhi R, "Does patient perception of alignment affect total knee arthroplasty outcome?", Can J Surg, 50, pp.181~186 (2007)
- Nilsdotter AK, "Knee arthroplasty : are patients’ expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up", Acta Orthop, 80, pp.55~61 (2009)
- Noble PC, "The John Insall Award : patient expectations affect satisfaction with total knee arthroplasty", Clin Orthop Relat Res, 452, pp.35~43 (2006)
- Anderson JG, "Functional outcome and patient satisfaction in total knee patients over the age of 75", J Arthroplasty, 11, pp.831~840 (1996)
- Robertsson O, "Patient satisfaction after knee arthroplasty : a report on 27, 372 knees operated on between 1981 and 1995 in Sweden", Acta Orthop Scand, 71, pp.262~267 (2000)
- Aspinal F, "Using satisfaction to measure the quality of palliative care : a review of the literature", J Adv Nurs, 42, pp.324~339 (2003)
- Baker PN, "National Joint Registry for England and Wales. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales", J Bone Joint Surg Br, 89, pp.893~900 (2007)
- Kwon SK, "Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty", J Arthroplasty, 25, pp.1125~1130 (2010)
- Lingard EA, "Patient expectations regarding total knee arthroplasty: differences among the United States, United Kingdom, and Australia", J Bone Joint Surg Am, 88, pp.1201~1207 (2006)
- Mahomed NN, "The importance of patient expectations in predicting functional outcomes after total joint arthroplasty", J Rheumatol, 29, pp.1273~1279 (2002)
- Bourne RB, "Comparing patient outcomes after THA and TKA: is there a difference?", Clin Orthop Relat Res, 468, pp.542~546 (2010)
- Brokelman R, "Patients are more satisfied than they expected after joint arthroplasty", Acta Orthop Belg, 74, pp.59~63 (2008)
- Eisler T, "Patient expectation and satisfaction in revision total hip arthroplasty", J Arthroplasty, 17, pp.457~462 (2002)
- Mancuso CA, "Randomized trials to modify patients’ preoperative expectations of hip and knee arthroplasties", Clin Orthop Relat Res, 466, pp.424~431 (2008)
- Seo ES, "Subcutaneous versus intraarticular indwelling closed suction drainage after TKA : a randomized controlled trial", Clin Orthop Relat Res, 468, pp.2168~2176 (2010)
- Farquhar S, "The Chitranjan Ranawat Award : The nonoperated knee predicts function 3 years after unilateral total knee arthroplasty", Clin Orthop Relat Res, 468, pp.37~44 (2010)
- Crowninshield RD, "Changing demographics of patients with total joint replacement", Clin Orthop Relat Res, 443, pp.266~272 (2006)
- Kim YH, "Comparison of a standard and a gender-specific posterior cruciate-substituting high-flexion knee prosthesis : a prospective, randomized, short-term outcome study", J Bone Joint Surg Am, 92, pp.1911~1920 (2010)
- Kane RL, "The functional outcomes of total knee arthroplasty", J Bone Joint Surg Am, 87, pp.1719~1724 (2005)
- Noble PC, "Does total knee replacement restore normal knee function?", Clin Orthop Relat Res, (431), pp.157~165 (2005)
- Weiss JM, "What functional activities are important to patients with knee replacements?", Clin Orthop Relat Res, (404), pp.172~188 (2002)
- Kanekasu K, "Fluoroscopic analysis of knee arthroplasty kinematics during deep flexion kneeling", J Arthroplasty, 19, pp.998~1003 (2004)
- Lee SY, "A posterior-stabilized total knee arthroplasty shows condylar lift-off during deep knee bends", Clin Orthop Relat Res, (435), pp.181~184 (2005)
- Nagura T, "Is high flexion following total knee arthroplasty safe? : evaluation of knee joint loads in the patients during maximal flexion", J Arthroplasty, 20, pp.647~651 (2005)
- Miner AL, "Knee range of motion after total knee arthroplasty: how important is this as an outcome measure?", J Arthroplasty, 18, pp.286~294 (2003)
- Park KK, "Correlation of maximum flexion with clinical outcome after total knee replacement in Asian patients", J Bone Joint Surg Br, 89, pp.604~608 (2007)
- Khanna A, "Minimally invasive total knee arthroplasty : a systematic review", Orthop Clin North Am, 40, pp.479~489 (2009)