Patient Satisfaction after Total Knee and Hip Arthroplasty

Background and purpose — Patient satisfaction is important in fast-track total hip and knee replacement (THR, TKR). We assessed: (1) how satisfied patients were with the treatment; (2) factors related to overall satisfaction; and (3) whether there was a difference between THR and TKR regarding length of stay (LOS) and patient satisfaction.Patients and methods — In this follow-up study, a consecutive series of 445 patients undergoing THR and TKR completed a questionnaire 2 weeks after discharge. LOS and short-term patient satisfaction with the fast-track management were measured. Patient satisfaction was measured using a numerical rating scale (NRS; 0–10).Results — For THR, the median satisfaction score was 9–10 and for TKR it was 8.5–10 in all parameters. Older THR patients had higher overall satisfaction. No association was found between overall satisfaction following THR or TKR and sex comorbidity, or LOS. THR patients had shorter mean LOS than TKR patients, even though the median LOS was 2 days for both groups. THR patients were more satisfied than TKR patients in the first weeks after discharge.Interpretation — Patient satisfaction is high following fast-track THR and TKR, with scores ranging from 8.5 to 10 on the NRS. A qualitative investigation of the first weeks after discharge is required to learn more about how to improve the experience of recovery.

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“…We found no association between gender and overall satisfaction in THR and TKR patients, as previously found by Lau et al (2012).…”

Section: Discussionsupporting

confidence: 68%

“…However, Husted et al (2008) found that patients with no comorbidities were more satisfied than patients with 1 or more comorbidities following THR and TKR. These conflicting findings about the effect of comorbidities on overall satisfaction were also discussed in a review by Lau et al (2012).…”

Section: Discussionmentioning

confidence: 94%

High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement

et al. 2015

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“…[22] According to the Lau et al, in evaluating the patient's satisfaction from surgery, external and internal factors should be investigated. [74] In addition, the present study found a positive and significant correlation between pre-operative clinical presentation and [75] Bourne et al reported that patients who had severe pain while sitting, sleeping, or lying in a bed before surgery reported less satisfaction from surgery. [22] Furthermore, Kim et al indicated that patient's satisfaction with knee replacement surgery was correlated with low WOMAC score before surgery.…”

Section: Discussionsupporting

confidence: 49%

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Gholamzadeh¹

2018

AJP

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Background: Knee replacement surgery is often successful; however, a number of patients are not satisfied with the results of the operation. Objectives: This study was designed to determine whether clinical presentation and quality of life (QoL) before knee replacement surgery could predict patient satisfaction with surgery. Materials and Methods: A cross-sectional study was performed among 250 elderly patients with the age of 60 years or over who were candidate for a unilateral knee replacement surgery in hospitals affiliated to Shiraz University of Medical Sciences. To gather data, the QoL Questionnaire, knee evaluation form, demographic, and satisfaction questionnaire were used. The questionnaires were filled-in before and after surgery and in follow-up time (2 months later). Results: Most of the respondents were women (66.4%) with the mean age of 68. 9 (standard deviation = 6. 84). The results showed a significant positive correlation between patients' post-operative satisfaction and pre-operative clinical presentation (r = 0.195 P = 0.003) and QoL (r =156, P = 0.023). However, there was no significant association between post-operative satisfaction and pre-operative clinical presentation and QoL at follow-up time (P > 0.05). Linear regression analysis showed that pre-operation clinical presentations and QoL, respectively, explained 3.8% and 2.4% of the variance in post-operative satisfaction. Conclusions:The results showed that satisfaction after surgery in the elderly is partly influenced by the pre-operative QoL and clinical presentation. Therefore, for improvement of the patients' post-operative outcomes, it is necessary to pay more attention to these variables in future planning.

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“…Reverse rotation patterns limited flexion, whereas normal rotation patterns seemed to position the lateral condyle more posterior, leading to more posterior clearance in deep flexion. In the normal knee, the lateral condyle has been shown to translate posteriorly, whereas the medial condyle remains relatively stationary for a small group of subjects analyzing knee flexion up to 90° [10]. This increased posterior translation resulted in an average of 16.5°normal rotation during a deep knee bend activity [4].…”

Section: Discussionmentioning

confidence: 98%

Abnormal Axial Rotations in TKA Contribute to Reduced Weightbearing Flexion

Meccia

Komistek

Mahfouz

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Previous in vivo fluoroscopy studies have documented that axial rotation for patients having a TKA was significantly less than those having a normal knee. In fact, many subjects having a TKA experience a reverse axial rotation pattern where the femur internally rotates with increasing flexion. However, no previous studies have been conducted to determine if this reverse axial rotation pattern affects TKA performance. Questions/purposes The purposes of this study were: (1) Do normal and reverse axial rotation patterns of a TKA affect the maximum flexion angle postoperatively? (2) Does the axial rotation angle of the knee at maximum flexion during weightbearing impact the magnitude of the maximum flexion achieved in weightbearing? Methods One hundred twenty patients having TKA, previously analyzed under in vivo conditions using fluoroscopy and a three-dimensional model-fitting software package, were further evaluated to determine if reverse axial rotation patterns limit weightbearing TKA flexion. In this retrospective cohort, we identified 58 patients who had a normal axial rotation pattern (greater than 15°normal rotation). Sixty-two patients experienced greater than 3°of reverse axial rotation, defined as internal rotation of the femur relative to the tibia. Results Patients having a normal axial rotation achieved greater weightbearing knee flexion than those with reverse axial rotation (115°versus 109°, p = 0.02). Additionally, patients with greater than 3°of normal axial rotation at maximum flexion had more flexion than those with less than 3°of normal axial rotation at ending flexion (115°v ersus 107°, p \ 0.001). Conclusions These findings show reverse axial rotation and a smaller magnitude of normal axial rotation reduce weightbearing knee flexion. This is likely the result of increased posterior movement of the lateral condyle and is an important consideration in future implant designs. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Patient Satisfaction after Total Knee and Hip Arthroplasty

Cited by 103 publications

References 72 publications

High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement

High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement

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Abnormal Axial Rotations in TKA Contribute to Reduced Weightbearing Flexion

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