Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Clin Orthop Relat Res. 2013 Jan;471(1):127-33. doi: 10.1007/s11999-012-2533-y.
Patient satisfaction has increasingly been recognized as an important measure after total knee arthroplasty (TKA). However, we do not know yet how and why the patients are satisfied or dissatisfied with TKA.
QUESTIONS/PURPOSES: We asked: (1) After TKA, how satisfied are patients and which activities were they able to do? (2) Are patient-derived scores related to physician-derived scores? (3) Which factors affect patient satisfaction and function?
We retrospectively evaluated 375 patients who had undergone 500 TKAs between February 22, 2000 and December 1, 2009. We sent a questionnaire for The 2011 Knee Society Knee Scoring System to the patients. We determined the correlation of patient- and physician-derived scores and factors relating to the five questions relating to satisfaction and the 19 questions relating function. The minimum followup was 2 years (mean, 5 years; range, 2-11 years).
The mean score for symptoms was 19 (74%), 23 (59%) for patient satisfaction, 10 (64%) for patient expectations, and 53 (53%) for functional activities. We found a poor correlation between the patient-derived and the physician-derived scores. Old age and varus postoperative alignment negatively correlated with the satisfaction. Varus alignment and limited range of motion (ROM) negatively correlated with the expectation. Old age, rheumatoid arthritis, and limited ROM negatively correlated with the functional activities.
Most patients did not report symptoms, but they experienced difficulty with activities of daily living after TKA. Patient satisfaction is difficult to measure, but avoiding varus alignment and achieving better ROM appear to be important for increasing satisfaction and meeting expectations.
患者满意度越来越被认为是全膝关节置换术（TKA）后的一个重要衡量标准。然而，我们还不知道患者对 TKA 满意或不满意的原因和方式。
问题/目的：我们提出以下问题：（1）TKA 后，患者的满意度如何，他们能够完成哪些活动？（2）患者自评分数与医生评分相关吗？（3）哪些因素影响患者的满意度和功能？
我们回顾性评估了 2000 年 2 月 22 日至 2009 年 12 月 1 日期间接受 500 例 TKA 的 375 例患者。我们向患者发送了《2011 年膝关节学会膝关节评分系统》问卷。我们确定了患者自评和医生评分的相关性，以及与满意度相关的五个问题和与功能相关的 19 个问题的相关因素。最低随访时间为 2 年（平均 5 年；范围，2-11 年）。
症状平均评分为 19 分（74%），患者满意度评分为 23 分（59%），患者期望评分为 10 分（64%），功能活动评分为 53 分（53%）。我们发现患者自评和医生评分之间相关性较差。高龄和术后内翻对线不良与满意度呈负相关。内翻对线和活动范围（ROM）受限与期望呈负相关。高龄、类风湿关节炎和 ROM 受限与功能活动呈负相关。
大多数患者没有报告症状，但在 TKA 后日常生活活动困难。患者满意度难以衡量，但避免内翻对线和获得更好的 ROM 似乎对于提高满意度和满足期望很重要。
