Abstract
Introduction
There is a growing recognition that evaluation should use patient-reported outcome tools and assessments of satisfaction in procedures like total knee replacement. These ensure that the patient's perception of outcome is included in the evaluation. Considering the increasing demands on physical function from the aging population, it is important to evaluate demanding physical activities for the population with end stage arthritis assigned for TKR.
Objectives
The aims of this prospective study were
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To describe the outcome (from the patient's perspective) one year after TKR
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To evaluate the patient satisfaction in terms of post op pain and functional outcome
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To identify preoperative characteristics predicting the postoperative outcome.
Material and methods
A retrospective as well as prospective study was done to analyse the satisfaction level, physical activity and quality of life after Total Knee Arthroplasty using a cemented modular posteriorly stabilized prosthesis one year after surgery using Knee injury and Osteoarthritis Outcome score (KOOS) and DMC & H General Patient Questionnaire. Clinical data was recorded and a proforma was filled of 104 patients operated from June 2010 till December 2012 of who consented and underwent Total Knee Arthroplasty at Dayanand Medical College and Hospital, Ludhiana.
Results
There was significant improvement in all KOOS subscale scores but post op sports/rec scores remained at the lowest level in the Likert scale. There was no significant effect of age, sex, duration of symptoms, number of co-morbidities and BMI on post op KOOS outcome scores and patient satisfaction. There was no significant difference in post op. mean pain and function scores in patients with higher and lower ranges of pre op scores, though patients with higher pre op scores had slightly higher post op scores. Mean postoperative Koos scores had trend of higher scores in RA patients as compared to OA patients. However there was no statistical significant difference in koos outcome scores between these two groups. Post op KOOS pain and ADL scores were comparable to patient satisfaction level.
Conclusion
Total knee replacement significantly improves patient's pain, symptoms, function and activities of daily living and knee related quality of life as more than 80% patients showed excellent satisfaction one year after surgery. Sports and recreational activities are not improved to the same extent as these activities were not applicable to more than 30 % of the patients. Patient satisfaction and fulfillment of expectations are comparable to KOOS sub scale scores. However, patient specific characters like age, sex, duration of symptoms, number of co-morbidities and BMI do not have significant effect on outcome measures.
