Patient Satisfaction after Total Knee Arthroplasty

Abstract

Total knee arthroplasty (TKA) is one of the most successful and effective surgical options to reduce pain and restore function for patients with severe osteoarthritis. The purpose of this article was to review and summarize the recent literatures regarding patient satisfaction after TKA and to analyze the various factors associated with patient dissatisfaction after TKA. Patient satisfaction is one of the many patient-reported outcome measures (PROMs). Patient satisfaction can be evaluated from two categories, determinants of satisfaction and components of satisfaction. The former have been described as all of the patient-related factors including age, gender, personality, patient expectations, medical and psychiatric comorbidity, patient's diagnosis leading to TKA and severity of arthropathy. The latter are all of the processes and technical aspects of TKA, ranging from the anesthetic and surgical factors, type of implants and postoperative rehabilitations. The surgeon- and patient-reported outcomes have been shown to be disparate occasionally. Among various factors that contribute to patient satisfaction, some factors can be managed by the surgeon, which should be improved through continuous research. Furthermore, extensive discussion and explanation before surgery will reduce patient dissatisfaction after TKA.

Kvalitet života pacijenata nakon implantacije totalne endoproteze koljena i medicinske rehabilitacije

“…Međutim, liječenje bolesnih zglobova ne završava se operativnim zahvatom. Krajnji cilj je osigurati pokret bez bola i time poboljšati pacijentov kvalitet života, koji Svjetska zdravstvena organizacija definiše kao multidimenzionalni model koji uključuje fizičko, emocionalno i socijalno dobro stanje, kao i individualni razvoj i svakodnevne aktivnosti [1][2][3]. Mjerenje kvaliteta života je važno radi donošenja pravovremene odluke o načinu liječenja i preduzimanja mjera za očuvanje svih segmenata kvaliteta života, prvenstveno fizičkih funkcija.…”

“…Nedavne studije sugerišu da su potrebna dalja istraživanja da bi se identifikovali pacijenti koji bi imali najviše koristi od intenzivne postoperativne rehabilitacije, kao i da se utvrdi optimalno vrijeme počinjanja rehabilitacije [2][3][4][5].…”

“…TKA je česta, pouzdana hirurška operacija koja se izvodi u kasnijim stadijumima degenerativne bolesti koljena, koja ima tendenciju da postane veliki zdravstveni problem sa mogućim uticajem na svakodnevni život. Većina pacijenata nakon artroplastike koljena prijavljuje zadovoljavajuće poboljšanje 3-6 mjeseci nakon operacije i nešto manje dodatno poboljšanje tokom naredne dvije godine [2][3][4][5].…”

The inter-relationship between clinical outcomes as measured by sagittal plane alignment of implant components, peri-operative kinematics, clinical ratings systems, strength, balance and functional performance assessment in patients post Total Knee Arthroplasty

“…Patients most commonly attribute their dissatisfaction to persistent pain, lack of improvement in function and perception of alignment [1,4]. Complex interactions between the patient, the surgeon and the implant dependant factors contribute to the outcome of TKA [4,5].…”

“…Failure of TKA has traditionally been measured by time to revision [1,2]. However, one in five patients are dissatisfied with the outcome of the operation without necessarily requiring a revision [4].…”