scholarly journals Does psychological distress influence postoperative satisfaction and outcomes in patients undergoing total knee arthroplasty? A prospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tao Bian ◽  
Hongyi Shao ◽  
Yixin Zhou ◽  
Yong Huang ◽  
Yang Song
Keyword(s):  
Total Knee Arthroplasty ◽  
Psychological Distress ◽  
Knee Arthroplasty ◽  
Regression Models ◽  
Psychological State ◽  
Linear Regression Models ◽  
Patients Satisfaction ◽  
Symptom Scores ◽  
Total Knee ◽  
Preoperative Score

Abstract Background Preoperative psychological distress may be related to dissatisfaction and poorer outcomes after total knee arthroplasty (TKA). However, the kind of psychological distress that could influence postoperative satisfaction and outcomes remains controversial. Few studies have examined these issues in Chinese cohorts. Thus, this study aimed to examine (1) the prevalence of preoperative psychological distress in patients undergoing TKA and (2) whether preoperative psychological distress influences patient satisfaction, early postoperative outcomes, and improvement of knee function after TKA. Methods We prospectively included 210 patients undergoing unilateral primary TKA between March 2017 and September 2017 at our institution. Preoperatively, patients completed the Depression Anxiety and Stress Scales and new Knee Society Scores (KSS) questionnaires. At 3 months and 1 year postoperatively, patients’ KSS and overall satisfaction were assessed. Stepwise multivariate linear regression models were used to assess the variables that influenced changes in each KSS item. Results Preoperatively, 89 (42.4%) patients experienced psychological distress. The satisfaction rate and postoperative KSS were not significantly different between patients with or without psychological distress; a higher preoperative score was shown to predict less KSS improvement. Patients with depression had fewer symptom score changes. Conclusions The prevalence of preoperative psychological distress was relatively high; thus, surgeons should consider the patient’s psychological state. Patients’ satisfaction was not influenced by psychological factors. Patients with depression and higher preoperative scores had lower symptom scores and KSS improvement, respectively.

Risk Factors for Tibial Component Oversizing in Total Knee Arthroplasty among African Americans

2019 ◽  
Vol 33 (03) ◽  
pp. 301-305
Author(s):  
Anand Padmanabha ◽  
Michael T. Li ◽  
David J. Tybor ◽  
Eric L. Smith
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
African American ◽  
African Americans ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Regression Models ◽  
Population Based ◽  
Linear Regression Models ◽  
Total Knee

AbstractIncidences and risk factors for tibial component oversizing in total knee arthroplasty (TKA) have been well described, predominantly in Caucasian samples. Component oversizing has been linked to variations in proximal tibial shape and morphology, which has been found to be objectively different in African Americans compared with Caucasians. These anthropometric differences may affect the conformity of modern TKA systems to the anatomy of African Americans undergoing TKA. We sought to investigate the incidence and risk factors for tibial baseplate oversizing in an exclusively African American population undergoing TKA with a symmetric tibial baseplate. We reviewed the records of self-reported African American patients who had undergone a primary TKA at a single academic institution between 2005 and 2016. The primary outcome was incidence of tibial baseplate oversizing in the coronal and sagittal planes as determined by a single set of appropriately rotated postoperative orthogonal radiographs. Logistic regression models identified trends in oversizing within the population based on age, sex, body mass index (BMI), and TKA model. Among all 525 knees being evaluated, the occurrences of medial and lateral overhang were 14.2 and 15.2%, respectively. Increase in age was associated with lower risk of medial tibial overhang (odds ratio = 0.97 for each 1-year increase in age). Simple linear regression models described a linear relationship between BMI and overhang, with every one-unit increase in BMI, medial tibial overhang is 0.031 mm higher and posterior tibial overhang is 0.062 mm higher. Mediolateral oversizing was approximately twice more likely in females than males. Among TKA models used, the Stryker Triathlon had the least risk for mediolateral oversizing and the P.F.C. SIGMA demonstrated the least propensity for anteroposterior oversizing. To conclude, incidence of mediolateral tibial oversizing in this population was common. Previously identified variables affecting proximal tibial morphology, including age, body morphotype, and gender, may be equally applicable to the conformity of tibial baseplates in this population. Surgeons must pay particular attention to avoid mediolateral tibial oversizing in this population, especially in obese and older patients.

scholarly journals How much improvement can satisfy patients? Exploring patients’ satisfaction 3 years after total knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiao Yu Fan ◽  
Jin Hui Ma ◽  
Xinjie Wu ◽  
Xin Xu ◽  
Lijun Shi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Minimal Clinically Important Difference ◽  
Important Change ◽  
Score Change ◽  
Patients Satisfaction ◽  
Clinically Important Difference ◽  
Total Knee ◽  
Hss Score ◽  
Varus Angle

Abstract Background Despite the innovations in total knee arthroplasty (TKA), there is still a subset of patients who do not acquire significant relief or expected satisfaction after primary TKA. However, this subgroup of patients still gains improvements more or less in terms of objective or quantified assessments after the procedure. The purpose of our study is to explore the factors that correlate with patients’ satisfaction and identify minimal clinically important difference (MCID) and minimum important change (MIC) in clinical parameters. Methods We conducted a retrospective study of 161 patients diagnosed with osteoarthritis who underwent unilateral total knee arthroplasty from January 2017 to December 2017. We collected the following parameters: body mass index (BMI), duration of disease, education level, depression state, preoperative flexion contracture angle of knee, HSS scores, 11-point NRS scores, and radiological parameters (preoperative minimal joint space width and varus angle of knee). The satisfaction was graded by self-reported scores in percentage (0–100). Results We revealed that 80.8% of patients were satisfied 3 years overall after primary TKA. HSS score change, NRS-Walking score change, age, and pre-mJSW showed significant difference between satisfied and dissatisfied group. The varus angle change revealed statistical significance according to the levels of satisfaction. Simple linear regression identified the MCID for HSS score to be 5.41 and for the NRS-Walking to be 1.24. The receiver operating characteristics (ROC) curve identified the MIC for HSS score to be 25.5 and for the NRS-Walking score to be 6.5. Conclusions In summary, we identified several factors that correlated with patients’ satisfaction independently after TKA in a long term. In addition, we revealed the minimal clinically important difference (MCID) and minimum important change (MIC) for HSS and NRS score in these patients.

scholarly journals Functional Factors of the Knee Joint and Body Which Improve Patients’ Satisfaction after Total Knee Arthroplasty

2018 ◽  
Vol 33 (3) ◽  
pp. 405-409
Author(s):  
Hiroki OYAGI ◽  
Kazuaki KINOSHITA ◽  
Kazunari ISHIDA ◽  
Nao SHIBANUMA
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Patients Satisfaction ◽  
Functional Factors ◽  
Total Knee

scholarly journals Decrease of Quality of Life, Functional Assessment and Associated Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty

2020 ◽  
Vol 9 (10) ◽  
pp. 3270
Author(s):  
Pilar Peña ◽  
Miguel A. Ortega ◽  
Julia Buján ◽  
Basilio De la Torre
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Psychological Distress ◽  
Functional Capacity ◽  
Knee Arthroplasty ◽  
Specific Patient ◽  
Womac Index ◽  
Total Knee ◽  
Mental Health Questionnaire

Total knee arthroplasty (TKA) is the final treatment for knee osteoarthritis, and 15–30% of patients show little or no improvement. This high percentage is related to aspects of the surgical technique, the selected implant, and specific patient characteristics. The aim of this study was to analyze whether there are differences in quality of life (QoL) and functional capacity among patients undergoing TKA with conventional implants compared to those treated with hypoallergenic oxinium implants. A pragmatic clinical study was carried out that included patients who underwent TKA between January 2013 and December 2015. During this period, 245 knees in 228 patients were treated. Eleven patients were excluded, leaving a sample of 161 conventionally treated knees, 72 knees treated with hypoallergenic implants, and one patient who received both implant types. In all patients, QoL and functional capacity were measured with the WOMAC index, the SF-12 questionnaire, and the Euro-Qol-5D L-VAS. We also assessed the psychological distress of each patient and related the findings to the functional results. The differences in QoL were tested using ANCOVA and propensity score matching (PSM) models adjusted for sex, age, weight, psychiatric history and associated complications. Patients who underwent TKA using conventional prostheses had significantly better scores on the total WOMAC index and in the pain domain (p < 0.05) than those who received hypoallergenic prostheses, but no significant differences were observed for the other domains in the ANCOVA. In contrast, with the PSM, we also found statistically significant differences in the difficulty domain of the WOMAC. Significant differences were found for the SF-12 mental health questionnaire results (p = 0.038), but the same did not occur for the physical health domain in the ANCOVA and PSM. We also found statistically significant differences in the Euro-Qol-5D index results (p = 0.041), but not in the VAS scale scores for the same questionnaire in the ANCOVA, and we did not find significant differences in either with the PSM. Patients with metal allergies and those who present psychological distress had WOMAC, SF-12, and Euro-Qol-5D results that were statistically significantly worse than those of patients who received conventional implants. Patients who underwent hypoallergic TKA had lower scores on the QoL and functional capacity scales than patients who received conventional Cr–Co implants. Additionally, patients with psychological distress had worse results on the questionnaires, and those with a metal allergy had even lower scores; the differences were statistically significant.

scholarly journals How Much Improvement Can Satisfy Patients? Exploring Patients’ Satisfaction 3 Years After Total Knee Arthroplasty

2021 ◽  
Author(s):  
xiaoyu fan ◽  
jinhui ma ◽  
xinjie wu ◽  
xin xu ◽  
lijun shi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Minimal Clinically Important Difference ◽  
Important Change ◽  
Score Change ◽  
Patients Satisfaction ◽  
Clinically Important Difference ◽  
Total Knee ◽  
Hss Score ◽  
Varus Angle

Abstract Background: Despite the innovations in total knee arthroplasty(TKA), there is still a subset of patients who do not acquire significant relief or expected satisfaction after primary TKA. However, this subgroup of patients still gains improvements more or less in terms of objective or quantified assessments after the procedure. The purpose of our study is to explore the factors that correlate with patients’ satisfaction and identify minimal clinically important difference(MCID) and minimum important change(MIC)in clinical parameters.Methods: We conducted a retrospective study of 161 patients diagnosed with osteoarthritis who underwent unilateral total knee arthroplasty from Jan. 2017-Dec. 2017. We collected the following parameters: body mass index(BMI), duration of disease, education level, depression state, preoperative flexion contracture angle of knee, HSS scores, 11-point NRS scores and radiological parameters(preoperative minimal joint space width and varus angle of knee). The satisfaction was graded by self-reported scores in percentage(0-100). Results: we revealed that 80.8% of patients were satisfied 3 years overall after primary TKA. HSS score change, NRS-Walking score change, age and Pre-mJSW showed significant difference between satisfied and dissatisfied group. The varus angle change revealed statistical significance according to the levels of satisfaction. Simple linear regression identified the MCID for HSS score to be 5.41 and for the NRS-Walking to be 1.24. The receiver operating characteristics (ROC) curve identified the MIC for HSS score to be 25.5 and for the NRS-Walking score to be 6.5. Conclusions: In summary, we identified several factors that correlated with patients’ satisfaction independently after TKA in a long-term. In addition, we revealed the minimal clinically important difference(MCID) and minimum important change(MIC)for HSS and NRS score.

scholarly journals Total Knee Arthroplasty Outcome for 129 Knees 80 Years and Older in Chinese Population

2021 ◽  
Author(s):  
Cheng-Qi Jia ◽  
Zhi-Lai Zhao ◽  
Yu-Jie Wu ◽  
Jun Fu ◽  
Chi Xu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Chinese Population ◽  
Operative Time ◽  
Inclusion Criteria ◽  
Tourniquet Time ◽  
Patients Satisfaction ◽  
Functional Scores ◽  
Total Knee

Abstract BackgroundSince China is aging rapidly, it is necessary to evaluate the reliability, durability, and satisfaction of total knee arthroplasty (TKA) among patients over 80 years.MethodsBetween February 2009 and December 2017, 98 patients (129 knees) met the inclusion criteria and were postoperatively followed-up ≥ 3 years. TKAs included 67 unilateral TKAs and 31 bilateral TKAs. The indexes included operative time, intraoperative blood loss, tourniquet time, Knee Society Score (KSS), Visual Analogue Scale (VAS), Range of Motion (ROM), “Forgotten Joint” Scale (FJS), crutches usage and patients’ satisfaction.ResultsKSS clinical and functional scores improved significantly from preoperative mean of 33 and 27 to latest follow-up of 87 and 51, respectively (p <0.05). The VAS decreased significantly from preoperative mean scores of 8 to latest follow-up of 0 (p <0.05). The proportion of patients without crutches at last follow-up was 52%, satisfaction rate was 94% and FJS ≥ 50 was 85%. However, ROM did not improve significantly from preoperative mean 89° to latest follow-up 93° (p >0.05). The preoperative hemoglobin and survival proportions between bilateral and unilateral TKAs were not statistically different (p >0.05).ConclusionTKA was reliable, durable, and satisfied in patients older than 80 years in Chinese population.

How Gait and Clinical Outcomes Contribute to Patients' Satisfaction Three Months Following A Total Knee Arthroplasty

2013 ◽  
Vol 28 (8) ◽  
pp. 1297-1300 ◽  
Author(s):  
Katia Turcot ◽  
Yoshimasa Sagawa ◽  
Daniel Fritschy ◽  
Pierre Hoffmeyer ◽  
Domizio Suvà ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Patients Satisfaction ◽  
Total Knee

scholarly journals The Impact of Personality Traits on the Outcome of Total Knee Arthroplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
A. Giurea ◽  
G. Fraberger ◽  
P. Kolbitsch ◽  
R. Lass ◽  
E. Schneider ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcome ◽  
Personality Traits ◽  
Knee Arthroplasty ◽  
Performance Orientation ◽  
Somatic Distress ◽  
Patients Satisfaction ◽  
Total Knee ◽  
Radiologic Investigation ◽  
The Impact

Ten to twenty percent of patients with total knee arthroplasty (TKA) are dissatisfied with their clinical outcome. Aim of this study was to investigate the impact of personality traits on the subjective outcome of TKA. We investigated 80 patients with 86 computer navigated TKAs. We asked for patients satisfaction and divided patients into two groups (satisfied or dissatisfied). 12 personality traits were tested by the Freiburg Personality Inventory (FPI-R). Postoperative examination included Knee Society Score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the Visual Analogue Scale (VAS). Radiologic investigation was done in all patients. 84% of our patients were satisfied, while 16% were not satisfied. The FPI-R showed statistical significant influence of four personality traits on patient satisfaction: life satisfaction (p=0.006), performance orientation (p=0.015), somatic distress (p=0.001), and emotional stability (p=0.002). All clinical scores (VAS, WOMAC, and KSS) showed significantly better results in the satisfied patient. Radiological examination showed optimal alignment of all TKAs. There were no complications requiring revision surgery. The results of our study show that personality traits may influence patients satisfaction and clinical outcome after TKA. Therefore patients personality traits may be a useful predictive factor for postoperative satisfaction after TKA.

scholarly journals Pre-operative arthritis severity as a predictor for total knee arthroplasty patients’ satisfaction

2013 ◽  
Vol 37 (7) ◽  
pp. 1257-1261 ◽  
Author(s):  
Christoph Schnurr ◽  
Maike Jarrous ◽  
Isabell Güdden ◽  
Peer Eysel ◽  
Dietmar Pierre König
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Arthritis Severity ◽  
Patients Satisfaction ◽  
Total Knee

scholarly journals Safety of Total Knee Arthroplasty in the Treatment of Knee Osteoarthritis and Its Effect on Postoperative Pain and Quality of Life of Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yunfeng Zhang ◽  
Hua Liu
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Number Of Patients ◽  
Total Knee ◽  
Preoperative Score

Objective. To explore the safety of total knee arthroplasty (TKA) in the treatment of knee osteoarthritis (KOA) and its impact on patients’ postoperative pain and quality of life. Methods. A total of 60 KOA patients admitted to our hospital from January 2019 to January 2020 were selected as the research objects. The knee joint scores (HSS) before and after TKA were compared, and the patients’ quality of life was evaluated using the Osteoarthritis Index of Western Ontario and McMaster University (WOMAC). At the same time, the number of patients with complications was recorded, and the efficacy of TKA was comprehensively analyzed. Results. The postoperative HSS score was significantly higher than the preoperative score ( P < 0.05 ), the postoperative pain score increased with time, and the pain gradually decreased. The postoperative WOMAC score was significantly lower than the preoperative score ( P < 0.001 ), and the score at 6 months after surgery was significantly lower than that at 3 months after surgery ( P < 0.001 ). There were no complications such as severe prosthesis fracture, secondary sepsis, and patellar tendon rupture, and the total incidence of complications was 11.7%. The effective rate of treatment at 6 months after operation was 98.3%, which was significantly higher than that at 3 months after operation ( P < 0.05 ). Conclusion. Total knee arthroplasty can improve the knee joint function of patients with knee osteoarthritis, with low postoperative pain, low complication rate, and good quality of life for patients. It is worthy of promotion and application.

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