Orthopaedic and Traumatology Department, Assiut University Hospital, Assiut, Egypt.
Public health department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Eur J Orthop Surg Traumatol. 2023 Oct;33(7):3019-3024. doi: 10.1007/s00590-023-03526-w. Epub 2023 Mar 22.
To predict the most important preoperative factor affecting the patient satisfaction after total knee arthroplasty (TKA) in trial to improve patient counselling process.
We retrospectively reviewed all patients who underwent primary TKA from January 1, 2018, to January 31, 2019, with minimum one-year follow-up for the previously collected patient-reported outcome measures (PROMs) as Oxford Knee Score (OKS) and Knee Injury and Osteoarthritis Outcome Score for joint replacement (KOOS, JR) preoperative, 6 months and 12 months postoperative.
By using Oxford knee score at 12 months as dependent variable, we found a negative moderate spearman correlation between age and Oxford knee score at 12 months postoperative. Moderate negative spearman correlation was also found between Oxford knee score at 12 months postoperative and KOOS pain, stiffness and function scores at preoperative and 6 months postoperative, denoting higher satisfaction at 12 months with less perceived stiffness, pain and limited function at baseline and 6 months postoperative. A multivariate regression analysis was done using the oxford knee score at 12 months as dependent variable to detect the predictors of oxford knee score at 12 months postoperatively and showed that younger age and less perception of stiffness at baseline were significant predictors of higher Oxford knee score: higher satisfaction at 12 months postoperative.
Preoperative stiffness can predict the postoperative satisfaction score more than any other factor. We also address the importance of combining more than one PROM in assessing patients as OKS and KOOS, JR.
预测全膝关节置换术(TKA)后影响患者满意度的最重要术前因素,以改善患者咨询流程。
我们回顾性分析了 2018 年 1 月 1 日至 2019 年 1 月 31 日期间接受初次 TKA 的所有患者,这些患者在之前收集的患者报告的结果测量(PROM)中至少有 1 年的随访,包括牛津膝关节评分(OKS)和膝关节损伤和骨关节炎评分(KOOS,JR)术前、术后 6 个月和 12 个月。
以 12 个月时的牛津膝关节评分为因变量,我们发现年龄与术后 12 个月时的牛津膝关节评分呈负相关,且具有中等强度的斯皮尔曼相关性。术后 12 个月时的牛津膝关节评分与术前和术后 6 个月时的 KOOS 疼痛、僵硬和功能评分也呈中度负相关,表明术后 12 个月时的满意度较高,而基线和术后 6 个月时的僵硬、疼痛和功能受限程度较低。使用 12 个月时的牛津膝关节评分为因变量进行多元回归分析,以检测术后 12 个月时的牛津膝关节评分的预测因素,结果显示,年龄较小和基线时僵硬感较轻是术后 12 个月时牛津膝关节评分较高的显著预测因素:术后 12 个月时满意度较高。
术前僵硬程度比其他任何因素都能更好地预测术后满意度评分。我们还强调了在评估患者时将多个 PROM(如 OKS 和 KOOS,JR)相结合的重要性。