Neuropathic pain-like symptoms and pre-surgery radiographic severity contribute to patient satisfaction 4.8 years post-total joint replacement

Background: Patient-reported outcomes (PROMs) are an integral part of national joint registers in measuring outcomes of operative procedures and improving quality of care. There is lack of literature comparing outcomes of total ankle replacement (TAR) to total knee replacement (TKR) and total hip replacement (THR). The aim of this study was to compare PROMs between TAR, TKR, and THR patient groups at 1, 5, and 10 years. Methods: Prospective PROMs from patients who underwent a TAR, TKR, or THR procedure between 2003 and 2010 were studied. Patients were divided into 3 groups based on their index joint replacement (hip, knee, or ankle). Patient demographics (age, gender, body mass index), patient-reported outcome scores (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], 36-Item Short Form Health Survey [SF-36]) and patient satisfaction scores (4-point Likert scale) at follow-up were compared between the 3 groups. Results: Data was available on 1797 THR, 2475 TKR, and 146 TAR patients. TAR patients were younger and reported fewer number of comorbidities. All 3 groups improved significantly from preoperative to 10 years for WOMAC scores ( P < .001). For SF-36 scores at 10 years, the THR group (32.2% follow-up) scored the highest for 3 domains ( P = .031) when compared to the TKR group (29.1% follow-up). All 3 groups had similar outcomes for 5 of 8 domains; P < .05). For patient satisfaction, the THR group reported overall 95.1% satisfaction followed by 89.8% for the TKR group and 83.9% in the TAR group (42.4% follow-up). Conclusion: In this cohort with diminishing numbers over the decade of time the patients were followed up we found that patients are equally happy with functional and general health outcomes from total ankle replacement vs other major lower extremity joint replacement. TAR surgery should be considered as a viable treatment option in this patient group. Level of Evidence: Level III, retrospective case series.

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ASSESSMENT OF PATIENT SATISFACTION WITH REHABILITATION MEASURES AFTER LOWER LIMB TOTAL JOINT REPLACEMENT

Internauka ◽

10.32743/26870142.2021.18.194.273891 ◽

2021 ◽

Vol 194 (18) ◽

Author(s):

Aidana Magauina ◽

Ainur Kumar ◽

Yerkebulan Magauin

Keyword(s):

Patient Satisfaction ◽

Joint Replacement ◽

Lower Limb ◽

Total Joint Replacement ◽

Rehabilitation Measures

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Outcome Domains and Measures in Total Joint Replacement Clinical Trials: Can We Harmonize Them? An OMERACT Collaborative Initiative

The Journal of Rheumatology ◽

10.3899/jrheum.141201 ◽

2015 ◽

Vol 42 (12) ◽

pp. 2496-2502 ◽

Cited By ~ 22

Author(s):

Jasvinder A. Singh ◽

Michael Dohm ◽

Andrew P. Sprowson ◽

Peter D. Wall ◽

Bethan L. Richards ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Patient Satisfaction ◽

Joint Replacement ◽

Working Group ◽

Total Joint Replacement ◽

Core Domain ◽

Trial Outcome ◽

Clinical Trial Outcome ◽

Core Domain Set

Objective.To develop a plan for harmonizing outcomes for people undergoing total joint replacement (TJR), to achieve consensus regarding TJR outcome research.Methods.The TJR working group met during the 2014 Outcome Measures in Rheumatology (OMERACT) 12 meeting in Budapest, Hungary. Multiple conference calls preceded the face-to-face meeting. Brief presentations were made during a 1.5-h meeting, which included an overview of published systematic reviews of TJR trials and the results of a recent systematic review of TJR clinical trial outcome domains and measures. This was followed by discussion of potential core set areas/domains for TJR clinical trials (as per OMERACT Filter 2.0) as well as the challenges associated with the measurement of these domains.Results.Working group participants discussed which TJR clinical trial outcome domains/areas map to the inner versus outer core for core domain set. Several challenges were identified with TJR outcomes including how to best measure function after TJR, elucidating the source of the pre- and post-TJR joint pain being measured, joint-specific versus generic quality of life instruments and the importance of patient satisfaction and revision surgery as outcomes. A preliminary core domain set for TJR clinical trials was proposed and included pain, function, patient satisfaction, revision, adverse events, and death. This core domain set will be further vetted with a broader audience.Conclusion.An international effort with active collaboration with the orthopedic community to standardize key outcome domains and measures is under way with the TJR working group. This effort will be further developed with new collaborations.

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