Abstract
Aims: To assess the reasons patients’ state for dissatisfaction with their total knee replacement and to confirm whether current follow-up procedures of TKR patients alert their consultant to the patients’ dissatisfaction.
Methods and Results: Whilst 83% of TKR patients registered on the Trent Arthroplasty database are satisfied with their arthroplasty at one year, 17% are dissatisfied or uncertain with the results of surgery.
All knee arthroplasty patients are sent a questionnaire one year post surgery to assess satisfaction and detect any complications.
In 1997/98 828 total knee replacements were performed in Leicester. 60% of patients returned their questionnaire and analysis of these indicated that 8% were dissatisfied and 9% unsure whether their TKR was successful.
In a significant proportion of dissatisfied or unsure patients (30%) no clinically identifiable cause could be found. In another 30% of patients a clinical cause could be speculated for their dissatisfaction. Within this group 34% were unhappy with the final flexion achieved, despite an acceptable range of movement after manipulation. When comparing these figures with total hip arthroplasty questionnaires performed during the same period a significantly higher proportion of knee arthroplasty patients expressed dissatisfaction. The consultants were unaware of patient dissatisfaction in 11 % of the total within this group due to their current follow up regimes. We were unable to detect any preventable causes within the dissatisfied/unsure group.
Conclusion: We suspect that a significant number of patients’ have unreasonably high expectations of TKR surgery and these expectations could be met in the preoperative counselling period.
Not all problems detected presented initially to the respective consultants due to current follow-up regimes.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
