Impact of socioeconomic factors on outcome of total knee arthroplasty

Abstract

Background: Several factors are associated to negative outcomes of total joint replacement such as inappropriate expectations, contralateral knee pain, higher psychological distress, high body mass index, use of a walking aid, advanced age, female gender, lower OA grade and thyroid disease Nonetheless, these findings are often not consistent across studies and the exact strength of the associations between these factors and the outcomes remain elusive. It thus remains a challenge to identify which TKA candidates will likely do well, or do poorly following TKA. Aim of the study:To study Impact of Socioeconomic Factors on Outcome of Total Knee Arthroplasty. Materials and methods: A total of 60 patients were selected with 30 patients selected from each low socioeconomic group and high socioeconomic group. Patients who had rheumatoid arthritis or were undergoing revision TKA were excluded from the study. Evaluation was done clinically using Knee society score (KSS), VAS Score and Modified Kuppusamy Socioeconomic status scale. Results: VAS score for Group 1 dropped significantly from 1 st postoperative day to 2 nd postoperative day. After 2 nd day, the VAS score decreased gradually. The mean VAS score in Group 2 decreased gradually from 1 st postoperative day to 14 th day postoperatively. On 24 th week postoperatively, the mean VAS score was similar in both the groups. The mean difference between Group 1 and Group 2 Knee society score preoperatively was 7.1. At time of discharge, the mean difference dropped to 3.04 and was observed to be 4 at 3 rd week post-operatively. The mean difference dropped gradually till 6 th month postoperatively. Majority of patients in Group 1 had DVT prophylaxis up to day 6, but it was up to day 9 in Group 2. Thus, low income is more strongly associated with satisfaction and functional outcomes in young patients after TKA than demographic or implant factors. Conclusion:Within the limitations of the present study, it can be concluded that it is certainly possible that socioeconomic factors, particularly household income, is strongly associated with satisfaction and functional results.