scholarly journals The effect of numbness on outcome from total knee replacement

2017 ◽  
Vol 99 (5) ◽  
pp. 385-389 ◽  
Author(s):  
J Blackburn ◽  
V Wylde ◽  
R Greenwood ◽  
AW Blom ◽  
A Levy
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Functional Limitations ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Self Report ◽  
Pain Subscale ◽  
Patient Reported ◽  
Total Knee ◽  
The Impact

INTRODUCTION Some patients report continuing pain and functional limitations after total knee replacement (TKR). While numbness around the TKR scar is common, the impact of numbness is less clear. One particular activity that could be influenced by numbness is kneeling. The aim of this study was to explore the impact of numbness around TKR scars on health related quality of life and kneeling ability. METHODS Fifty-six patients were recruited one year after primary TKR. Sensation around the knee was assessed through patient self-reporting, monofilament testing and vibration, and patients’ distress was measured on a visual analogue scale. Patient reported outcome measures (PROMs) including the Western Ontario and McMaster Universities (WOMAC®) index, the Knee injury and Osteoarthritis Outcome Score (KOOS), the painDETECT® (Pfizer, Berlin, Germany) questionnaire and the EQ-5D™ (EuroQol, Rotterdam, Netherlands) questionnaire were used. Participants were also asked about kneeling ability. RESULTS While 68% of patients reported numbness around their TKR scar, there was no statistically significant correlation between numbness and distress at numbness (self-report: 0.23, p=0.08; monofilament: 0.15, p=0.27). Furthermore, numbness did not correlate significantly with joint specific PROMs (WOMAC®: 0.21, p=0.13; KOOS: 0.18, p=0.19). However, difficulty with kneeling did correlate with both self-reported numbness (0.36, p=0.020) and worse PROM scores (WOMAC® pain subscale: 0.62, p<0.001; KOOS: 0.64, p<0.001). CONCLUSIONS Numbness after knee replacement is common but is not associated with worse patient reported outcomes.

scholarly journals PROMs in total knee replacement: analysis of negative outcomes

2021 ◽  
Vol 103 (1) ◽  
pp. 64-73
Author(s):  
F Begum ◽  
A Panagiotidou ◽  
C Park ◽  
T Ashdown ◽  
S El-Tawil
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Oxford Knee Score ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Replacement Policy ◽  
Health Gains ◽  
Patient Reported ◽  
Post Operation ◽  
Total Knee

Introduction NHS England uses the Oxford Knee Score (OKS) as part of patient-reported outcome measures (PROMs) to evaluate ‘health gains’ following total knee replacement. Policy makers use this to guide healthcare funding and resource allocation. Our study aims to undertake a qualitative and quantitative analysis of OKS among patients who experienced a negative outcome after a total knee replacement at our centre. Materials and methods Between April 2017-March 2018, 19 of 189 (10%) patients had a worsened OKS at our centre. We retrospectively and prospectively reviewed 14 of these patients. Structured telephone interviews with a repeat OKS were carried out in September 2019 (18–29 months post-operation). Results Eight patients were female and the total age range was 57–95, mean average 75.6 (SD 9.9 years). Of 48 (higher scores meaning better outcomes), the average preoperative OKS was 24.2 and the average postoperative OKS at 6 months was 19.4 (decrease of 20%). The average postoperative OKS at 18–29 months was 35.6 (an increase of 83.5% from 6 months). Discussion The OKS was developed and validated over 20 years ago in Oxford. In our study, four patients asked for clarification of questions 4, 6 and 10 owing to ambiguous language. All 14 patients who had negative OKS outcomes had positive outcomes when retested after 18 months, depicting ‘health gains’ not conveyed in PROMs analysis. Conclusion The OKS needs to be revalidated on current patient groups for accurate and reliable data. Further prospective studies should be undertaken on larger cohorts to understand the recovery course and whether PROMs should be carried out later.

The effect of tibial component sizing on patient reported outcome measures following uncemented total knee replacement

The Knee ◽  
2014 ◽  
Vol 21 (5) ◽  
pp. 955-959 ◽  
Author(s):  
Simon G.F. Abram ◽  
Andrew G. Marsh ◽  
Alistair S. Brydone ◽  
Fiona Nicol ◽  
Aslam Mohammed ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Outcome Measures ◽  
Knee Replacement ◽  
Tibial Component ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Component Sizing ◽  
Patient Reported ◽  
Total Knee

Preoperative Factors Affecting the Patient-Reported Outcome Measures following Total Knee Replacement: Socioeconomic Factors and Preoperative OKS Have a Clinically Meaningful Effect

2021 ◽  
Author(s):  
Charis Demetriou ◽  
Jeremy Webb ◽  
Philip Sedgwick ◽  
Irrum Afzal ◽  
Richard Field ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Patient Reported Outcome ◽  
Multiple Deprivation ◽  
Vas Score ◽  
Patient Reported ◽  
Total Knee ◽  
Index Of Multiple Deprivation ◽  
Eq Vas ◽  
Preoperative Factors

AbstractThe Oxford Knee Score (OKS) is a patient-reported outcome questionnaire typically used to assess function and pain in patients undergoing total knee replacement (TKR). However, research is inconclusive as to which preoperative factors are important in explaining variation in outcome following TKR. The operative records of 12,709 patients who underwent primary TKR over a 9-year period were analyzed. The following variables were collected for each patient: age, sex, body mass index (BMI), Index of Multiple Deprivation decile rank, side of operation, diagnosis, the American Society of Anaesthesiologists (ASA) grade, preoperative OKS, EQ-5D index score, EuroQol visual analog scale (EQ-VAS) score, the postoperative OKS at 1 and 2 years. Generalized linear regression models were performed at 1 and 2 years to investigate the effect of the preoperative variables on the postoperative OKS. The effect of age, sex, BMI, Index of Multiple Deprivation decile rank, diagnosis, ASA grade, preoperative OKS, EuroQoL five-dimensional (EQ-5D) index score, and EQ-VAS score were all statistically significant in explaining the variation in OKS at 1 and 2 years postoperatively, with critical level of significance of 0.05 (5%). Being male aged 60 to 69 years of normal BMI, ASA grade I (fit and healthy), living in an affluent area, not reporting preoperative anxiety/depression, were associated with an enhanced mean postoperative OKS at both 1 and 2 years. When adjusted for potential confounding, age of 60–69 years, male sex, normal BMI, lower ASA grade, higher Index of Multiple Deprivation and higher pre-operative EQ-5D, EQ-VAS and OKS were identified as factors that resulted in higher post-operative OKS after primary TKR.

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