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Lookup NU author(s): Michelle Bardgett, Dr Jennifer Holland, Craig Gerrand, Professor David Deehan
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© 2018 The British Editorial Society of Bone & Joint Surgery. Aims The primary aim of this study was to assess the rate of patient satisfaction one year after total knee arthroplasty (TKA) according to the focus of the question asked. The secondary aims were to identify independent predictors of patient satisfaction according to the focus of the question. Patients and Methods A retrospective cohort of 2521 patients undergoing a primary unilateral TKA were identified from an established regional arthroplasty database. Patient demographics, comorbidities, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 12-Item Short-Form Health Survey (SF-12) scores were collected preoperatively and one year postoperatively. Patient satisfaction was assessed using four questions, which focused on overall outcome, activity, work, and pain. Logistic regression analysis was used to identify independent preoperative predictors of increased stiffness when adjusting for confounding variables. Results Using patient satisfaction with the overall outcome (n = 2265, 89.8%) as the standard, there was no difference in the rate of satisfaction for pain relief (n = 2277, odds ratio (OR) 0.95, 95% confident intervals (CI) 0.79 to 1.14, p = 0.60), but patients were more likely to be dissatisfied with activities (79.3%, n = 2000/2521, OR 2.22, 95% CI 1.96 to 2.70, p < 0.001) and work (85.8%, n = 2163/2521, OR 1.47, 95% CI 1.23 to 1.75, p < 0.001). Logistic regression analysis identified different predictors of satisfaction for each of the focused satisfaction questions. Overall satisfaction was influenced by diabetes (p = 0.03), depression (p = 0.004), back pain (p < 0.001), and SF-12 physical (p = 0.008) and mental (p = 0.01) components. Satisfaction with activities was influenced by depression (p = 0.001), back pain (p < 0.001), WOMAC stiffness score (p = 0.03), and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with work was influenced by depression (p = 0.007), back pain (p < 0.001), WOMAC function (p = 0.04) and stiffness (p = 0.05) scores, and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with pain relief was influenced by diabetes (p < 0.001), back pain (p < 0.001), and SF-12 mental component (p = 0.04). Conclusion The focus of the satisfaction question significantly influences the rate and the predictors of patient satisfaction after TKA.
Author(s): Clement ND, Bardgett M, Weir D, Holland J, Gerrand C, Deehan DJ
Publication type: Article
Publication status: Published
Journal: Bone and Joint Journal
Year: 2018
Volume: 100B
Issue: 6
Pages: 740-748
Print publication date: 01/06/2018
Online publication date: 01/06/2018
Acceptance date: 02/04/2018
ISSN (print): 2049-4394
ISSN (electronic): 2049-4408
Publisher: British Editorial Society of Bone and Joint Surgery
URL: https://doi.org/10.1302/0301-620X.100B6.BJJ-2017-1292.R1
DOI: 10.1302/0301-620X.100B6.BJJ-2017-1292.R1
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