Is It the Surgeon, the Patient, or the Device? A Comprehensive Clinical and Radiological Evaluation of Factors Influencing Patient Satisfaction in 648 Total Knee Arthroplasties

Rissolio, Lorenzo; Sabatini, Luigi; Risitano, Salvatore; Bistolfi, Alessandro; Galluzzo, Umberto; Massè, Alessandro; Indelli, Pier Francesco

doi:10.3390/jcm10122599

Cited by 7 publications

(16 citation statements)

References 40 publications

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“…Smoking status, which was a significant predictor of patient satisfaction in the current analysis, has rarely been assessed so far in this context. Only two studies examining the impact of smoking on patient satisfaction were found [45,46]. Rissolio et al assessed long-term outcomes of TKA (minimum follow-up: 24 months) and reported no association between smoking and surgery outcome satisfaction [45].…”

Section: Patient Satisfactionmentioning

confidence: 99%

“…Only two studies examining the impact of smoking on patient satisfaction were found [45,46]. Rissolio et al assessed long-term outcomes of TKA (minimum follow-up: 24 months) and reported no association between smoking and surgery outcome satisfaction [45]. Halawi et al, however, who assessed patient satisfaction six and 12 months after TKA, found smokers to be less satisfied versus non-smokers (82% vs. 89%, p = 0.052) -independent of their psychological health status [46].…”

Section: Patient Satisfactionmentioning

confidence: 99%

“…Halawi et al, however, who assessed patient satisfaction six and 12 months after TKA, found smokers to be less satisfied versus non-smokers (82% vs. 89%, p = 0.052) -independent of their psychological health status [46]. A possible reason for these opposing results could be that smoking increases the risk for periprosthetic joint infections, surgical complications, and wound complications, which may have a larger impact in the short-and medium-term [46] than in the long term [45].…”

Section: Patient Satisfactionmentioning

confidence: 99%

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The influence of obesity on functional outcomes and patient satisfaction 8 weeks after total knee arthroplasty: results of the prospective FInGK study

Baum

Jacobs

Lazovic

et al. 2022

BMC Musculoskelet Disord

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Objectives To investigate obese versus non-obese subjects´ knee joint function, stiffness, pain, expectations, and outcome satisfaction before and two months after total knee arthroplasty (TKA). Methods This study is a secondary analysis of data retrieved via a prospective single-centre cohort study investigating knee joint function and health care services utilization in patients undergoing TKA (FInGK Study). For the primary study, elective TKA patients were consecutively recruited between December 2019 and May 2021. Preoperative expectations, Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC), surgery outcome satisfaction, and sociodemographic variables were assessed via self-reported questionnaires. In the current study, obese (Body Mass Index (BMI) ≥ 30 kg/m²) versus non-obese (BMI < 30 kg/m²) subjects’ data were exploratively compared before and two months after TKA. Multivariable logistic regression assessed factors associated with TKA satisfaction two months postoperatively. Linear regression evaluated factors associated with higher WOMAC change two months postoperatively. Results A total of 241 subjects participated (response: 85.2%). Eighty-seven were non-obese (mean age: 70.7 years, 63.2% female) and 154 were obese (mean age: 67.1 years, 57.8% female). Obese subjects reported inferior pre- and postoperative pain and knee joint function compared to non-obese subjects. Yet, WOMAC scores of obese and non-obese subjects significantly improved from preoperative means of 52.6 and 46.8 to 32.3 and 24.4 after surgery, respectively. The only significant TKA satisfaction predictor was subjects’ smoking status. Non-obesity and worse preoperative WOMAC scores were predictive of higher WOMAC change scores after two months. Conclusion Both obese and non-obese subjects reported significant symptom improvements. However, as obese subjects’ short-term outcomes were still inferior, more research on TKA rehabilitation measures adapted to the needs of this growing patient group is warranted to maximize their benefits from TKA.

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Section: Patient Satisfactionmentioning

confidence: 99%

Section: Patient Satisfactionmentioning

confidence: 99%

Section: Patient Satisfactionmentioning

confidence: 99%

See 1 more Smart Citation

The influence of obesity on functional outcomes and patient satisfaction 8 weeks after total knee arthroplasty: results of the prospective FInGK study

Baum

Jacobs

Lazovic

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…This difference is in line with other studies [ 12 , 13 ]. Furthermore, women demonstrated poorer clinical outcomes and lower satisfaction after surgery [ 14 , 15 ]. The gender difference has also been analyzed in other reviews, concluding that women are at increased risk for developing more severe postoperative pain conditions and subsequent CSPS [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Pain Course after Total Knee Arthroplasty within a Standardized Pain Management Concept: A Prospective Observational Study

Schindler

Schmitz

Reinhard

et al. 2022

JCM

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Background: Joint replacement surgeries have been known to be some of the most painful surgical procedures. Therefore, the options for postoperative pain management are of great importance for patients undergoing total knee arthroplasty (TKA). Despite successful surgery, up to 30% of the patients are not satisfied after the operation. The aim of this study is to assess pain development within the first 4 weeks after TKA in order to gain a better understanding and detect possible influencing factors. Methods: A total of 103 patients were included in this prospective cohort study. Postoperative pain was indicated using a numeric rating scale (NRS). Furthermore, demographic data and perioperative parameters were correlated with the reported postoperative pain. Results: The evaluation of postoperative pain scores showed a constant decrease in the first postoperative week (mean NRS score of 5.8 on day 1 to a mean NRS score of 4.6 on day 8). On day 9, the pain increased again. Thereafter, a continuous decrease in pain intensity from day 10 on was noted (continuous to a mean NRS score of 3.0 on day 29). A significant association was found between postoperative pain intensity and gender, body mass index (BMI), and preoperative leg axis. Conclusions: The increasing pain score after the first postoperative week is most likely due to more intensive mobilization and physiotherapy in the rehabilitation department. Patients that were female, had a low BMI, and a preoperative valgus leg axis showed a significantly higher postoperative pain scores. Pain management should consider these results in the future to improve patient satisfaction in the postoperative course after TKA.

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“…Numerous studies have attempted to identify factors driving this high dissatisfaction rate. There is growing evidence that unfulfilled preoperative expectations are important determinants of patients’ dissatisfaction with TKA [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring expectations of Chinese patients for total knee arthroplasty: once the medicine is taken, the symptoms vanish

Yang

Yang²,

Li³

et al. 2023

BMC Musculoskelet Disord

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Background Preoperative expectations of total knee arthroplasty (TKA) outcomes are important determinants of patient satisfaction. However, expectations of patients in different countries are affected by cultural background. The general goal of this study was to describe Chinese TKA patients’ expectations. Methods Patients scheduled for TKA were recruited in a quantitative study(n = 198). The Hospital for Special Surgery Total Knee Replacement Expectations Survey Questionnaire was used for survey TKA patients’ expectations. Descriptive phenomenological design was used for the qualitative research. Semi-structured interviews were conducted with 15 TKA patients. Colaizzi’s method was used for interview data analysis. Results The mean expectation score of Chinese TKA patients was 89.17 points. The 4 highest score items were walk short distance, remove the need for walker, relieve pain and make knee or leg straight. The 2 lowest score items were employed for monetary reimbursement and sexual activity. Five main themes and 12 sub-themes emerged from the interview data, including multiple factors raised expectations, expectations of physical comfort, expect various activities back to normal, hope for a long joint lifespan, and expect a better mood. Conclusions Chinese TKA patients reported a relatively high level of expectations, and differences across cultures result in different expectation points than other national populations, requiring adjustment of items when using assessment tools across cultures. Strategies for expectation management should be further developed. Level of evidence Level IV.

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Is It the Surgeon, the Patient, or the Device? A Comprehensive Clinical and Radiological Evaluation of Factors Influencing Patient Satisfaction in 648 Total Knee Arthroplasties

Cited by 7 publications

References 40 publications

The influence of obesity on functional outcomes and patient satisfaction 8 weeks after total knee arthroplasty: results of the prospective FInGK study

The influence of obesity on functional outcomes and patient satisfaction 8 weeks after total knee arthroplasty: results of the prospective FInGK study

Pain Course after Total Knee Arthroplasty within a Standardized Pain Management Concept: A Prospective Observational Study

Exploring expectations of Chinese patients for total knee arthroplasty: once the medicine is taken, the symptoms vanish

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