Patients’ perspective on controversial issues in total knee arthroplasty

Abstract

We investigated the level of patient knowledge and preferences over the currently controversial issues in TKA. One hundred patients who had decided to undergo TKA for advanced osteoarthritis were asked to complete a questionnaire inquiring their knowledge and preferences over three controversial issues: (1) computer assisted surgery (CAS), (2) minimal invasive surgery (MIS), and (3) ceramic femoral component. The patient preferences over the three issues were questioned again after they had been informed of advantages and disadvantages of each option using an explanatory document. Most (more than 75%) of the patients did not have sufficient knowledge and their knowledge was based on non-professional sources (more than 85%). Before the information was given, most (more than 80%) of the patients preferred a new option. After the information was provided, more patients preferred a standard option in the issues of CAS (60%) and MIS (88%). This study prompts health care providers to become more active in providing accurate information and to consider patients perspective in making decisions which will influence the benefits and risk of the patients.

Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?

“…Although the literature suggests high survival rates for conventional TKAs [36], patients often have major concerns regarding postoperative pain and length of recovery [7,24]. Surgeons have attempted to achieve additional improvement in postoperative outcomes by reducing the size and number of incisions [4,28,41].…”

“…Also, the promise of a faster recovery time with less pain and less unsightly scarring through MIS has motivated patients to explore the possibility of undergoing these MIS techniques for their TKA [24,46]. It therefore is important to clarify the role and benefits of MIS TKA for surgeons who want to offer the option of MIS TKA to patients.…”

Minimalinvasive Zugänge am Kniegelenk - evidenzbasierter Vorteil in der Knieendoprothetik?

“…Vor der Informationsvermittlung waren 80 % der Patienten positiv gegenüber Neuerungen eingestellt. Nach der Information wollten nur noch 12% der Patienten eine MIS-Technik in Anspruch nehmen [59]. " Welche Krankenhäuser und welche Operateure können die Anwendung dieser Technik erwägen?…”

Modelling Knee Range of Motion Post Arthroplasty: Clinical Applications

“…Although range of motion (ROM) may not be a strong predictor of function (quality of life, performance-based measures) at 6 months and beyond, [3][4][5] it is important in the early post-arthroplasty stages and can be a significant predictor of patient dissatisfaction. 6 Patients with persistent stiffness (flexion contracture and/or limited flexion) who do not show improvement with standard rehabilitation may become candidates for additional operations, such as manipulations under anaesthesia or arthroscopic debridement, the outcomes of which are variable and do not approach the results of primary knee arthroplasty. 7,8 It is imperative that physical therapists identify and appropriately address ROM challenges early, before the 6-to 9-week period post arthroplasty when restrictions are often detected, so as to avoid additional operations.…”

“…Although numerous studies have examined intraoperative and post-arthroplasty care, [10][11][12][13][14][15][16] the typical study design compares pre-arthroplasty pain and function measurements to post-arthroplasty measurements obtained at fixed time-points (e.g., 3,6, and 12 months). Although these fixed-point comparisons provide sufficient information to comment on the effectiveness of total knee arthroplasty (TKA) and supplementary interventions, they offer limited information about the rate and determinants of change.…”