Department of Orthopedic Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.
J Knee Surg. 2021 Nov;34(13):1441-1445. doi: 10.1055/s-0040-1710384. Epub 2020 May 13.
Predicting postoperative outcomes following total knee arthroplasty (TKA) is important for patient selection. This study focuses on patient-reported outcomes and satisfaction in relation to preoperative radiographic arthritis severity. A retrospective chart review of 420 TKAs was performed. Patient satisfaction was determined using a structured telephone survey with questions focused on degree of satisfaction whether they would have surgery again and their ability to kneel. The radiographic severity of the arthritis of the tibiofemoral joint was graded by a musculoskeletal radiologist using the Kellgren-Lawrence grading scale. The patellofemoral compartment was graded using the scale described by Jones et al. Those grouped as severe arthritis had an overall satisfaction rate of 96% (76% fully satisfied and 20% partially satisfied) compared with 82% of the time (64% fully satisfied and 18% partially satisfied) if their arthritis was mild. Postoperatively 51% of TKA patients were able to kneel. Univariate logistic regression showed an association between higher rates of satisfaction and male gender ( = 0.053), severity of preoperative radiographic arthritis ( = 0.034) those who would have surgery again ( ≤ 0.0001) and those able to kneel ( = 0.005). Patients should be informed preoperatively that if their arthritis is only mild radiographically, their outcomes are less predictable. There should also be a discussion surrounding kneeling and activities patients do, which may require kneeling, as many are unable to kneel postoperatively. The Level of Evidence for the study is III.
预测全膝关节置换术（TKA）后的手术效果对于患者选择非常重要。本研究主要关注与术前放射学关节炎严重程度相关的患者报告结果和满意度。对 420 例 TKA 进行了回顾性图表审查。使用结构化电话调查来确定患者满意度，调查问题集中在患者的满意度程度、是否会再次接受手术以及他们的下跪能力。通过肌肉骨骼放射科医生使用 Kellgren-Lawrence 分级量表对胫股关节的关节炎放射学严重程度进行分级。使用 Jones 等人描述的量表对髌股关节进行分级。如果关节炎为严重程度，则总体满意度为 96%（76%完全满意，20%部分满意），而关节炎为轻度程度时，满意度为 82%（64%完全满意，18%部分满意）。术后 51%的 TKA 患者能够下跪。单变量逻辑回归显示，满意度较高与男性性别（ = 0.053）、术前放射学关节炎严重程度（ = 0.034）、再次接受手术的意愿（ = 0.0001）和能够下跪（ = 0.005）有关。应在术前告知患者，如果他们的关节炎仅在影像学上轻度，那么手术效果的可预测性较低。还应讨论下跪和患者进行的可能需要下跪的活动，因为许多患者术后无法下跪。本研究的证据水平为 III 级。
