Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore.
Arch Orthop Trauma Surg. 2021 Jan;141(1):129-137. doi: 10.1007/s00402-020-03612-2. Epub 2020 Oct 12.
There is poor correlation between functional outcomes and patient satisfaction following total knee arthroplasty (TKA). We asked if early post-operative scores at 6 months or the pre- to post-operative change in scores are predictive of patient satisfaction 2 years after TKA.
We conducted a retrospective review of prospectively collected registry data of 4359 TKAs performed at a single institution. At 6 months and 2 years, the Knee Society Score (KSS), Oxford Knee Score (OKS), and Short-Form 36 scores were assessed. A satisfaction questionnaire was also completed. Logistic regression was used to generate receiver-operating characteristic (ROC) curves to assess the ability of each scoring system in predicting satisfaction at 2 years.
At 2 years, 91.1% of patients were satisfied. For the absolute post-operative OKS at 6 months, an AUC of 0.762 (95% CI 0.736-0.788) and a threshold of ≤ 21.5 points (or ≥ 38.5 points on the new scale) were obtained. For the KSS knee score, an AUC of 0.704 (95% CI 0.674-0.734) and a threshold of ≥ 80.5 points were identified. The OKS performed significantly better than the KSS knee score (p = 0.03) and the other post-operative scores (p < 0.001). When analysing the change in scores pre-operatively to 6 months, the AUC was < 0.7 for all scales.
Early post-operative scores, specifically the OKS and KSS knee score, can predict patient satisfaction at 2 years after TKA with good accuracy. The threshold values offer surgeons an additional tool to identify patients at risk of dissatisfaction at 2 years, enabling them to intervene earlier to ensure good patient satisfaction.
III, retrospective cohort study.
全膝关节置换术（TKA）后，功能结果与患者满意度之间的相关性较差。我们想知道术后 6 个月的早期评分或评分的术前到术后变化是否可以预测 TKA 后 2 年的患者满意度。
我们对一家机构进行的前瞻性收集登记数据的 4359 例 TKA 进行了回顾性分析。在 6 个月和 2 年时，评估了膝关节协会评分（KSS）、牛津膝关节评分（OKS）和 36 项简短健康调查问卷评分。还完成了满意度问卷。使用逻辑回归生成受试者工作特征（ROC）曲线，以评估每个评分系统预测 2 年时满意度的能力。
2 年后，91.1%的患者感到满意。对于术后 6 个月的绝对 OKS，AUC 为 0.762（95%CI 0.736-0.788），阈值为≤21.5 分（或新量表上的≥38.5 分）。对于 KSS 膝关节评分，AUC 为 0.704（95%CI 0.674-0.734），阈值为≥80.5 分。OKS 的表现明显优于 KSS 膝关节评分（p=0.03）和其他术后评分（p<0.001）。当分析术前到 6 个月的评分变化时，所有量表的 AUC 均<0.7。
术后早期评分，特别是 OKS 和 KSS 膝关节评分，可以很好地预测 TKA 后 2 年的患者满意度。阈值为外科医生提供了一种额外的工具，可识别 2 年后不满意风险的患者，使他们能够更早地进行干预，以确保患者满意度高。
III，回顾性队列研究。
