QUALITY OF LIFE: IDENTIFICATION OF PROGNOSTIC FACTORS AND ASSESSMENT AT THREE YEARS IN TKR PATIENTS

Abstract

Introduction: The variability of clinical results and the complexity and cost of total knee replacement (TKR) require efficacy assessments and the determination of prognostic factors with the aim of optimizing this procedure.

Purpose:

1. Study of the evolution at 36 months of health-related quality of life (HRQofL) in patients with significant knee arthritis that undergo TKR and

2. Identification of social, demographic and clinical variables that affect HRQofL.

Materials and methods: This is a three-year prospective study. HRQofL was assessed by means of a specific WOMAC questionnaire. An assessment was made of the following: sociodemographic characteristics of the population, their knee arthritis, intraoperative parameters, complexity of the operation and immediate and late postoperative complications. The statistical study was performed using linear regression models. During the preoperative period 90 patients were included.

Results: On assessment at 3 years we were able to assess 67 patients (54 were women); mean age: 74.83, SD 5.57. Pre-postoperative evolution determined by the specific HRQofL questionnaire shows significant differences in improvement at 3 years. Non-knee-arthritis related pain has been associated with worse results in the different WOMAC dimensions (pain, stiffness and function). Morbid obesity (IMC & #8805;38) was significantly associated with severe pain.

Conclusions: In patients with severe gonarthrosis that undergo TKR, HRQofL has improved when assessment is performed 3 years later. No significant differences are found between intra and postoperative variables in the evolution of HRQofL. The presence of non-gonarthrosis related chronic pain and morbid obesity are negative factors in postoperative WOMAC assessment.