Patient Dissatisfaction After Primary Total Joint Arthroplasty: The Patient Perspective

Halawi, Mohamad J.; Jongbloed, Walter; Baron, Samuel; Savoy, Lawrence; Williams, Vincent; Cote, Mark P.

doi:10.1016/j.arth.2019.01.075

Cited by 153 publications

(107 citation statements)

References 23 publications

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“…In evaluation of the VAS for patient satisfaction, a high correlation between a patient's pain score and Oxford hip score suggested that pain was one of the most important factors in patient satisfaction [5,6]. Additional studies have also supported this claim, citing pain relief as a critical component of maximizing patient satisfaction after THA [4,[27][28][29]. Pre-operative pain management using nonsteroidal anti-inflammatory drugs (NSAIDs) has been associated with improved recovery [33,34], increasing both overall satisfaction and pain satisfaction as measured by a short HCAHPs survey [33].…”

Section: Pain Managementmentioning

confidence: 99%

“…Patient expectations are widely discussed in current THA outcomes research [12,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], along with compliance with evidence-based guidelines. Similar to patient satisfaction, patient expectation is a complex and dynamic quality that is difficult to define, measure, and analyze [30].…”

Section: Patient Expectationsmentioning

confidence: 99%

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Patient satisfaction and total hip arthroplasty: a review

Okafor

Chen

2019

Arthroplasty

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Primary total hip arthroplasty (THA) has been recognized as a reliable intervention for patients with end-stage osteoarthritis. Despite several notable advances in this procedure, studies have identified at least 7% of patients who remain dissatisfied. There is no general consensus on how to measure patient satisfaction in orthopedic surgery. However, validated tools have been used in multiple studies to further investigate this problem. A comprehensive review was conducted to examine the factors associated with patient satisfaction following THA. Associations in literature included patient expectation, age, sex, pain management, patient comorbidities (medical or psychiatric that existed prior to surgery), and length of stay. The continuous collection of patient satisfaction data using validated and reliable measurement tools is necessary to improve this important patient-reported outcome after THA.

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Section: Pain Managementmentioning

confidence: 99%

Section: Patient Expectationsmentioning

confidence: 99%

Patient satisfaction and total hip arthroplasty: a review

Okafor

Chen

2019

Arthroplasty

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“…The analysis of the total knee arthroplasty (TKA) demonstrates that up to 20% of the patients are not satisfied with their knee function after TKA [1]. Pain, instability, and limitation of the range of motion are the most commonly reported symptoms among unsatisfied patients [1,2]. Inadequate alignment and gap balancing have been implicated as major potential causes of these limitations [2,3].…”

mentioning

confidence: 99%

Accuracy of a New Robotically Assisted Technique for Total Knee Arthroplasty: A Cadaveric Study

Parratte

Price

Jeys

et al. 2019

The Journal of Arthroplasty

112

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Background: Although the utility of robotic surgery has already been proven in cadaveric studies, it is our hypothesis that this newly designed robotically assisted system will achieve a high level of accuracy for bone resection. Therefore, we aimed to analyze in a cadaveric study the accuracy to achieve targeted angles and resection thickness. Methods: For this study, 15 frozen cadaveric specimens (30 knees) were used. In this study, Zimmer Biomet (Warsaw, IN) knees, navigation system, and robot (ROSA Knee System; Zimmer Biomet) were used. Eight trained, board-certified orthopedic surgeons performed robotically assisted total knee arthroplasty implantation using the same robotic protocol with 3 different implant designs. The target angles obtained from the intraoperative planning were then compared to the angles of the bone cuts performed using the robotic system and measured with the computer-assisted system considered to be the gold standard. For each bone cut the resection thickness was measured 3 times by 2 different observers and compared to the values for the planned resections. Results: All angle mean differences were below 1 and standard deviations below 1. For all 6 angles, the mean differences between the target angle and the measured values were not significantly different from 0 except for the femoral flexion angle which had a mean difference of 0.95. The mean hip-knee-ankle axis difference was À0.03 ± 0.87. All resection mean differences were below 0.7 mm and standard deviations below 1.1mm. Conclusion: Despite the fact that this study was funded by Zimmer Biomet and only used Zimmer Biomet implants, robot, and navigation tools, the results of our in vitro study demonstrated that surgeons using this new surgical robot in total knee arthroplasty can perform highly accurate bone cuts to achieve the planned angles and resection thickness as measured using conventional navigation. Funding: This study is funded Zimmer Biomet.

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“…However, patient satisfaction is a multidimensional concept that may represent either satisfaction with outcome (e.g. knee function) of TKA or the process of care delivery, which all can be influenced by patients' expectations (14,28). Halawi et al explored subjective reasons for patient dissatisfaction after TJR and found different causes of patient dissatisfaction.…”

Section: Patient Dissatisfactionmentioning

confidence: 99%

“…Halawi et al explored subjective reasons for patient dissatisfaction after TJR and found different causes of patient dissatisfaction. The most common causes for dissatisfaction after TKA were persistent pain, functional limitation, surgical complication and reoperation, staff or quality of care issues and unmet expectations (28). It is likely that different factors influence the construct of patients satisfaction, and therefore it is important to determine the different determinants that contribute to patients satisfaction after TKA according to the perspective of patients and orthopaedic surgeons.…”

Section: Patient Dissatisfactionmentioning

confidence: 99%

Definitions of poor outcome after total knee arthroplasty: An inventory review

Molder¹,

Smolders²,

Heesterbeek³

et al. 2019

Preprint

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Background: A significant proportion of patients shows poor response (i.e. no or little improvement) after total knee arthroplasty (TKA) because of osteoarthritis. It is difficult to quantify the proportion of patients with poor response to TKA, as different definitions of, and perspectives (clinician’s and patient’s) on poor response are being used. The aim of this study was therefore to review the literature and summarize definitions of poor response to TKA. Methods: A systematic search was performed to identify and review studies that included dichotomous definitions of poor outcome after primary TKA. The type, amount and combination of domains (e.g. functioning), outcome measures, type of responses (absolute/relative, change/cut-off), values and moments of follow-up used in definitions were summarized. Results: A total of 46 different dichotomous definitions of poor response to TKA were extracted from 2163 initially identified studies. 35 definitions incorporated one domain, seven definitions comprised two domains and four definitions comprised three domains. Eight different domains were used in identified definitions: pain, function, physical functioning, quality of life (QoL), patient satisfaction, anxiety, depression and patient global assessment. The absolute cut-off value was the most common type of response, with large variety in value and timing of follow-up. Conclusions: Our inventory review shows that definitions of poor response to TKA are heterogeneous. Our findings stresses the need for an unambiguous definition of poor response to draw conclusions about the prevalence of poor-responders to TKA across hospitals and countries, and to identify patients at risk.

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Patient Dissatisfaction After Primary Total Joint Arthroplasty: The Patient Perspective

Cited by 153 publications

References 23 publications

Patient satisfaction and total hip arthroplasty: a review

Patient satisfaction and total hip arthroplasty: a review

Accuracy of a New Robotically Assisted Technique for Total Knee Arthroplasty: A Cadaveric Study

Definitions of poor outcome after total knee arthroplasty: An inventory review

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