Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands.
BMC Musculoskelet Disord. 2010 Jun 16;11:121. doi: 10.1186/1471-2474-11-121.
After total knee arthroplasty (TKA) only 75-89% of patients are satisfied. Because patient satisfaction is a prime goal of all orthopaedic procedures, optimization of patient satisfaction is of major importance. Factors related to patient satisfaction after TKA have been explored, but no studies have included two potentially relevant factors, i.e. the functional capacity of daily activities and actual daily activity. This present prospective study examines whether functional capacity and actual daily activity (in addition to an extensive set of potential factors) contribute to patient satisfaction six months after TKA.
A total of 44 patients were extensively examined preoperatively and six months post surgery. Functional capacity was measured with three capacity tests, focusing on walking, stair climbing, and chair rising. Actual daily activity was measured in the patient's home situation by means of a 48-hour measurement with an Activity Monitor. To establish which factors were related to patient satisfaction six months post surgery, logistic regression analyses were used to calculate odds ratios.
Preoperative and postoperative functional capacity and actual daily activity had no relation with patient satisfaction. Preoperatively, only self-reported mental functioning was positively related to patient satisfaction. Postoperatively, based on multivariate analysis, only fulfilled expectations regarding pain and experienced pain six months post surgery were related to patient satisfaction.
Functional capacity and actual daily activity do not contribute to patient satisfaction after TKA. Patients with a better preoperative self-reported mental functioning, and patients who experienced less pain and had fulfilled expectations regarding pain postoperatively, were more often satisfied.
全膝关节置换术后仅有 75-89%的患者满意。因为患者满意度是所有矫形手术的首要目标，所以优化患者满意度非常重要。已经探讨了与 TKA 后患者满意度相关的因素，但没有研究包括两个潜在的相关因素，即日常活动的功能能力和实际日常活动。本前瞻性研究检查了 TKA 后 6 个月时功能能力和实际日常活动（除了广泛的潜在因素之外）是否对患者满意度有影响。
共有 44 名患者在术前和术后 6 个月进行了广泛检查。功能能力通过三项能力测试来测量，重点是行走、爬楼梯和坐起。实际日常活动通过活动监测仪在患者的家庭环境中进行 48 小时测量来测量。为了确定哪些因素与术后 6 个月的患者满意度相关，使用逻辑回归分析计算优势比。
术前和术后的功能能力和实际日常活动与患者满意度无关。术前，只有自我报告的心理功能与患者满意度呈正相关。术后，基于多变量分析，只有对疼痛的期望得到满足和术后 6 个月时感到疼痛与患者满意度相关。
功能能力和实际日常活动与 TKA 后的患者满意度无关。术前自我报告的心理功能较好的患者，以及术后疼痛减轻且对疼痛的期望得到满足的患者，往往更满意。
