FUNCTION SCORES AFTER TOTAL KNEE REPALCEMENT ARE INFLUENCED BY SOCIO-ECONOMIC STATUS

Abstract

This study was carried out to evaluate the impact of Socio-Economic Status (SES) and the influence of geographic access to health services on the possible outcomes of total knee replacement (TKR).

Data on 345 patients with one year follow-up were collected from the database of the orthopaedic department. TKR outcomes were assessed according to Knee Society Score (KSS). A postcode was assigned to each patient depending on the residential area and data from the last census was used to calculate Scottish Index of Multiple Deprivation Score (SIMD) and its rating score for geographic access to health services.

The results show that the SES and the geographic access to medical services have significant impact on Function Scores but do not influence Knee Scores.

Patients living in the least deprived regions had a better post-operative Function Scores compared to those living in more deprived regions with differences of up to 13 points between groups (p< 0.001). Similarly the improvement in Function Scores was dependant on deprivation score. (p=0.015). Pre-operative Knee Score, post-operative Knee Score and improvement in Knee Scores were not influenced by deprivation score.

Patients living in rural regions had better post-operative Function Scores and greater improvements in Function Score compared to urban dweller patients (p≤0.011) with differences of up to 17 points. The Knee Score was not influenced by these variables.

These results suggest that SES and the region of residence should be considered when assessing the outcomes of TKR.