Martinson Eliott Sophie, Clement Nick D, Leitch Gillian, Scott Chloe E H
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Bone Jt Open. 2025 Aug 21;6(8):983-990. doi: 10.1302/2633-1462.68.BJO-2025-0105.R1.
The Oxford Knee Score (OKS) is an established and validated outcome measure of knee arthroplasty (KA), but it is not clear how responses to each of the 12 questions relate to satisfaction. The aim was to assess which of 12 OKS questions were associated with patient satisfaction after KA.
This single-centre retrospective cohort study was conducted over an eight-year period from January 2014 to December 2021. A total of 3,361 patients completed preoperative and six months postoperative OKS. The mean age was 69.9 years (34 to 94, SD 9.3), and 1,792 were female (55.0%). Patient satisfaction with their KA was assessed at six months, which was categorized into satisfied (satisfied, very satisfied) and dissatisfied (neutral, dissatisfied, very dissatisfied).
All 12 questions demonstrated significant improvements postoperatively (p < 0.001), with moderate (q2/3/7) to large (q1/4/5/6/8/9/10/11/12) effect sizes. There were 2,704 patients (82.9%) who were satisfied with their KA at six months. Satisfied patients had significantly greater improvements (p < 0.001) in each of the OKS questions, with the greatest differences found in questions 6 (limping; mean difference (MD) 1.41 (95% CI 1.29 to 1.53)) and 1 (pain; MD 1.32 (95% CI 1.22 to 1.42)). Preoperative responses to each of the OKS questions demonstrated poor discriminatory ability to predict patient satisfaction (area under the curve < 0.70). Improvement in questions 1 (pain; odds ratio (OR) 1.72 (95% CI 1.51 to 1.96), p < 0.001), 6 (limping; OR 1.28 (95% CI 1.16 to 1.41), p < 0.001), 7 (kneeling; OR 1.20 (95% CI 1.06 to 1.35), p = 0.003), 8 (night pain; OR 1.11 (95% CI 1.01 to 1.23), p = 0.038), 9 (working; OR 1.21 (95% CI 1.05 to 1.39), p = 0.015), and 12 (stairs; OR 1.42 (95% CI 1.25 to 1.63), p < 0.001) were independently associated with satisfaction.
Improvements in six of the 12 OKS questions were independently associated with patient satisfaction; these could be prioritized as areas to be addressed following KA, and modification of related patient expectations may improve satisfaction with surgery.
牛津膝关节评分（OKS）是一种已确立且经过验证的膝关节置换术（KA）疗效评估指标，但尚不清楚对12个问题的回答与满意度之间的关系。本研究旨在评估OKS的12个问题中哪些与KA术后患者满意度相关。
本单中心回顾性队列研究在2014年1月至2021年12月的八年期间进行。共有3361例患者完成了术前和术后六个月的OKS评分。平均年龄为69.9岁（34至94岁，标准差9.3），其中1792例为女性（55.0%）。在术后六个月评估患者对KA的满意度，分为满意（满意、非常满意）和不满意（中立、不满意、非常不满意）。
所有12个问题术后均有显著改善（p<0.001），效应量为中等（问题2/3/7）至较大（问题1/4/5/6/8/9/10/11/12）。术后六个月有2704例患者（82.9%）对KA满意。满意的患者在每个OKS问题上的改善都显著更大（p<0.001），在问题6（跛行；平均差（MD）1.41（95%置信区间1.29至1.53））和问题1（疼痛；MD 1.32（95%置信区间1.22至1.42））中差异最大。术前对每个OKS问题的回答预测患者满意度的鉴别能力较差（曲线下面积<0.70）。问题1（疼痛；比值比（OR）1.72（95%置信区间1.51至1.96），p<0.001）、问题6（跛行；OR 1.28（95%置信区间1.16至1.41），p<0.001）、问题7（跪姿；OR 1.20（95%置信区间1.06至1.35），p = 0.003）、问题8（夜间疼痛；OR 1.11（95%置信区间1.01至1.23），p = 0.038）、问题9（工作；OR 1.21（95%置信区间1.05至1.39），p = 0.015）和问题12（上下楼梯；OR 1.42（95%置信区间1.25至1.63），p<0.001）的改善与满意度独立相关。
OKS的12个问题中的6个问题的改善与患者满意度独立相关；这些问题可作为KA术后需要关注的重点领域，调整相关患者期望可能会提高手术满意度。
