A 5 year prospective study of patient-relevant outcomes after total knee replacement

Nilsdotter, Anna; Toksvig‐Larsen, Sören; Roos, Ewa M.

doi:10.1016/j.joca.2008.11.007

Cited by 149 publications

(156 citation statements)

References 16 publications

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“…This result contradicts the conclusions of a previous longitudinal study in which the best functional and clinical outcomes were obtained within 12 months, followed by significant deterioration in terms of function, pain and vitality at 5 years [10]. Complementary studies should be designed to determine the long-term evolution of patient-reported symptoms, function and satisfaction after TKR.…”

Section: Discussioncontrasting

confidence: 75%

“…Over the last 3 decades, long-term follow-up studies reported constant improvement in implant survival [2][3][4][5][6][7][8]. In parallel, several prospective studies highlighted significant clinical and functional improvement on composite scores such as Knee injury and Osteoarthritis Outcome Score (KOOS) [9,10], Knee society score (KSS) [11,12], and Western Ontario and McMaster osteoarthritis index (WOMAC) [13,14], or reported satisfaction rates exceeding 80% [14][15][16], confirming that TKR outcomes are generally good. However, in long-term follow-up, orthopaedic surgeons and also GPs and rheumatologists may face some patients who do not find the operated knee totally natural despite absence of functional limitations or pain.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

“Forgotten knee” after total knee replacement: A pragmatic study from a single-centre cohort

Eymard¹,

Charles-Nelson²,

Katsahian³

et al. 2015

Joint Bone Spine

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Section: Discussioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

“Forgotten knee” after total knee replacement: A pragmatic study from a single-centre cohort

Eymard¹,

Charles-Nelson²,

Katsahian³

et al. 2015

Joint Bone Spine

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“…This trend undoubtedly will continue as we support an increasingly aging population and perform primary surgery on a more demanding younger population [6]. Primary TKA almost uniformly relieves pain, improves knee function, and produces levels of patient satisfaction greater than 80% [2,17,21,24,26,28,[32][33][34]. Revision surgery is less predictable, with lower rates of survival, increased rates of complications, varied patient satisfaction, and an inconsistent ability to restore or improve quality of life [8,12,18,29].…”

Section: Introductionmentioning

confidence: 99%

Reason for Revision Influences Early Patient Outcomes After Aseptic Knee Revision

Baker

Cowling

Kurtz

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Revision TKA less consistently produces improvements in clinical function and quality of life when compared with primary TKA. The reasons for this difference are unclear. Questions/purposes We determined differences in patientreported outcomes and rates of satisfaction between primary and revision TKAs, and determine whether the reason for revision influences patient-reported outcomes after revision TKA. Methods We retrospectively analyzed prospectively collected patient-reported outcome measures (PROMs) for 24,190 patients (23,393 TKAs; 797 aseptic revision TKAs). We compared patient-reported outcomes using the Oxford Knee Score (OKS), EuroQol (EQ-5D), and patient satisfaction between primary TKA and revision TKA, and for subsets of the revision TKA cohort. The followup data were collected between 6 and 12 months (7 months average) postoperatively. Results Improvements in the OKS (10) and EQ-5D (0.231) were smaller after revision when compared with primary TKA (OKS, 15; EQ-5D, 0.303). Patients who had revision TKA were less satisfied (66% versus 83%). Revisions for aseptic loosening or lysis were associated with the best patient outcomes (OKS improvement = 11; EQ-5D improvement = 0.232; satisfaction = 72%). Revisions for stiffness had the worst results (OKS improvement = 6; EQ-5D improvement = 0.176; satisfaction = 47%). Conclusions The early improvements in knee function and general health after revision TKA are only 69% to 76% of those observed for primary TKA. Levels of patient-reported knee function, general health, and satisfaction after revision are varied and related to the reason for revision. Even the best revision group does not approach the levels of function and satisfaction observed after primary TKA at a mean of 7 months postoperatively.

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“…As careful followup is needed in these high activity patients, the Knee Society added evaluation items for patients with sports activities in the new Knee Society Knee Scoring System [24]. KOOS sports activities consist of "jumping" and "running", and these items made it possible to evaluate the knee function and symptoms in high activity patients which KOOS ADL could not [25]. KOOS would be a good parameter for activities in highly active patients such as younger patients after TKA.…”

Section: Discussionmentioning

confidence: 99%

Relationship between patient-based outcome score and conventional objective outcome scales in post-operative total knee arthroplasty patients

Sasaki

Tsuda

Yamamoto

et al. 2013

International Orthopaedics (SICOT)

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Purpose Evaluations for knee osteoarthritis (OA) or postoperative total knee arthroplasty (TKA) have mainly been assessed by objective scales. Though the Knee injury and Osteoarthritis Outcome Score (KOOS) is attracting attention as a patient-based outcome score, the relationship with conventional objective scales after TKA remains controversial. The purpose of this study was to investigate the relationship between KOOS and conventional objective scales and evaluate the features of patient-based outcome scores. Methods Subjects were 130 post-operative patients involving 186 knees treated with TKA. Their mean age was 74.0± 8.0 years, and the follow-up period was 43 months. Japanese Orthopaedic Association (JOA) score, original Knee Society Score (KSS) and surgeon's satisfaction score were scored as conventional objective scales besides KOOS. Spearman's correlation coefficient was estimated between these scales. Comparisons between OA and rheumatoid arthritis (RA) as well as primary and revision surgery were performed by the Mann-Whitney U test. Results There were strong correlations between KOOS activities of daily living (ADL) and JOA score (r =0.806), KSS function score (r =0.803) and between KOOS pain and KSS knee score (r =0.689). However, there was a poor correlation between KOOS and surgeon's satisfaction score (r =0.188-0.321). TKA for RA showed poorer results only in KOOS pain (p =0.003), and revision surgery showed poorer results in KSS function, KOOS symptoms and KOOS quality of life (QOL). Conclusions This study suggested that conventional objective scales reflected mainly ADL disturbances in post-operative TKA patients. Furthermore, patient-based outcome scores made it possible to evaluate and detect a minute change of knee pain and QOL in TKA patients. The Japanese KOOS was a useful tool to evaluate conditions after TKA.

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A 5 year prospective study of patient-relevant outcomes after total knee replacement

Cited by 149 publications

References 16 publications

“Forgotten knee” after total knee replacement: A pragmatic study from a single-centre cohort

“Forgotten knee” after total knee replacement: A pragmatic study from a single-centre cohort

Reason for Revision Influences Early Patient Outcomes After Aseptic Knee Revision

Relationship between patient-based outcome score and conventional objective outcome scales in post-operative total knee arthroplasty patients

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