TOTAL DİZ ARTROPLASTİSİ SONRASI KLİNİK SONUÇLAR VE HASTA MEMNUNİYETİ: KİMLER DAHA MEMNUN?

Year 2022, Volume: 55 Issue: 2, 94 - 98, 31.08.2022

İzzet Korkmaz Nurdan Korkmaz

https://doi.org/10.20492/aeahtd.1061341

Abstract

AMAÇ: Primer diz osteoartriti nedeni ile total diz artroplastisi (TDA) uygulanan hastaların ağrı, fonksiyonel durum ve memnuniyet düzeylerini değerlendirmek ve memnuniyet düzeyi ile demografik ve klinik özellikler arasındaki ilişkiyi incelemek amaçlanmıştır.
GEREÇ VE YÖNTEM: Evre III veya IV primer diz osteoartriti nedeniyle TDA uygulanmış, operasyon üzerinden bir yıl geçmiş ve yeterli takibi olan 44 hastanın kayıtları retrospektif olarak tarandı. Demografik ve klinik özellikleri kaydedildi. Operasyon öncesi ve operasyon sonrası birinci yılda Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) ağrı şiddeti ve fonksiyonu değerlendirmek için kullanıldı. Hastaların operasyon sonrası birinci yıldaki memnuniyet düzeyi 5 puanlık bir likert skala ile değerlendirildi.
BULGULAR: Tüm WOMAC skorları (WOMAC-ağrı, WOMAC-tutukluk, WOMAC-fonksiyon ve WOMAC-total) cerrahi sonrası birinci yılda cerrahi öncesine kıyasla istatistiksel anlamlı olarak düşüş gösterdi. TDA sonrası birinci yılda çok memnun ve memnun olan hastaların oranı %93,2 idi. Memnuniyet düzeyi, tüm WOMAC skorları ile istatistiksel olarak anlamlı negatif ilişki gösterdi. Kadın, yalnız yaşayan, bekar/dul, egzersiz programına devamlılık göstermeyen ve diğer vücut bölgelerinden kaynaklanan kas-iskelet ağrısı olanların memnuniyet düzeyi daha düşüktü (tüm p<0,05).
SONUÇ: Çalışmamız, TDA’nın ileri evre primer diz osteoartriti olan hastalarda ağrı ve fonksiyonel durumda önemli iyileşmelerin saptandığı ve hastaların çoğunluğunda memnuniyetin sağlandığı bir tedavi yöntemi olduğunu desteklemektedir. Memnuniyet düzeyi, operasyon sonrası ev egzersiz programına devamlılığın sağlanması ve özellikle kadın, bekar/dul ve yalnız yaşayan hastaların sosyal olarak desteklenmesi ile arttırılabilir. Ayrıca memnuniyetsiz hastalarda diğer bölgelerden kaynaklanan kas-iskelet ağrılarının olabileceği de unutulmamalıdır.

Keywords

Diz artroplastisi, ağrı, fonksiyonel durum, Hasta Memnuniyeti

CLINICAL RESULTS AND PATIENT SATISFACTION AFTER TOTAL KNEE ARTROPLASTY: WHO ARE MORE SATISFIED?

Abstract

AIM: It was aimed to evaluate the pain, functional status and satisfaction levels of patients who underwent total knee arthroplasty (TKA) for primary knee osteoarthritis and to examine the relationship between satisfaction levels and demographic and clinical characteristics.
MATERIAL AND METHOD: The data of 44 patients who underwent TKA due to stage III or IV primary knee osteoarthritis, one-year after the operation and who had adequate follow-up were analyzed retrospectively. Demographic and clinical features were recorded. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate pain severity and function before surgery and one-year after surgery. The satisfaction level of the patients in the first year after the operation was assessed with a 5-point Likert scale.
RESULTS: All WOMAC scores (WOMAC-pain, WOMAC-stiffness, WOMAC-function, and WOMAC-total) decreased statistically significantly at one-year after surgery compared to pre-surgery. The proportion of patients who were very satisfied and satisfied at one-year after TKA was 93.2%. Female, single/widowed, not compliant with home exercise program, and those with musculoskeletal pain originating from other regions had lower satisfaction levels (all p<0.05).
CONCLUSION: Our study supported that TKA is a treatment modality in which significant improvements in pain and functional status were detected in patients with advanced primary knee osteoarthritis and satisfaction was achieved in the majority of patients. The level of satisfaction can be increased by ensuring the continuity of the home exercise program after the operation and socially supporting especially female, single/widowed and lonely lived patients. In addition, it should not be ignored that dissatisfied patients may have musculoskeletal pain originating from other regions.

Keywords

knee arthroplasty, pain, functional status, Patient Satisfaction

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