PRIMARY TOTAL KNEE ARTHROPLASTY IN PATIENTS RECEIVING WORKER’S COMPENSATION BENEFITS

Abstract

A retrospective review was conducted to evaluate short-term (one year) outcomes of primary total knee arthroplasty (TKA) patients receiving Ontario Worker’s Safety and Insurance Board Benefits (WSIB) compared to a matched cohort of non-WSIB patients. Postoperatively, WSIB patients had higher pain scores, poorer self-perceived functional outcomes and lower flexion range. WSIB patients required more postoperative clinic visits and were more reluctant to answer questions regarding functional outcome. All differences were statistically significant. The short-term outcomes of primary TKA in patients receiving WSIB benefits are inferior to those obtained by non-WSIB patients.

Retrospective review to evaluate short-term outcomes of primary TKA patients receiving WSIB as compared to non-WSIB patients.

Short-term outcomes of primary TKA in WSIB patients are inferior both subjectively and objectively to non-WSIB patients. WSIB patients are seen more frequently for postoperative follow-up which we would attribute to the persistence of subjective complaints following primary TKA.

Short-term outcomes of primary TKA in WSIB patients are inferior to those obtained by non-WSIB patients. WSIB patients undergoing primary TKA require more postoperative visits with a greater prevalence of subjective postoperative complaints.

Thirty-eight WSIB patients who underwent primary TKA were matched to thirty-eight non-WSIB patients. There were no statistical differences in preoperative Knee Society (KSS) and Oxford Score. Six-week total KSS (p=0.011), pain as measured by KSS (p=0.015), and flexion (p=0.012) were significantly different between the groups. At six-months similar results were noted among KSS function (p=0.027) and pain (p=0.024), Oxford Score (p=0.027), and flexion (p=0.035). One-year Oxford Score (p=.011) and flexion (p=0.013) were statistically significant, as were the McGrory Modified Knee Score (p=0.001), patient expectations (p=0.030), perceived quality of life (p=0.009), and number of postoperative clinic visits (p=0.024).

Retrospective review on successive WSIB patients undergoing primary TKA, at a single arthroplasty centre, matched to a cohort of non-WSIB patients for demographics and preoperative diagnosis. Outcomes included Knee Society, Oxford Knee, and McGrory et al Modified Knee scores, patient satisfaction, and number of postoperative clinic visits. Unpaired t-tests were used to determine differences in outcomes.

There are few reports but many allusions regarding inferior outcomes of TKA in WSIB patients. Our study provides further evidence to support this view. Multiple factors may account for this variance, including psychosocial factors. Further prospective studies are needed to address this burgeoning issue.