Kafkas J Med Sci 2017; 7(2):139–143 doi: 10.5505/kjms.2017.68726 ARAŞTIRMA MAKALESİ / RESEARCH ARTICLE Preoperative and Postoperative Factors Affecting Patient Satisfaction After Total Knee Arthroplasty

Yıl 2017, , 139 - 143, 01.08.2017

Pınar Küçük Eroğlu Yeşim Garip , Şahap Cenk Altun

https://doi.org/10.5505/kjms.2017.68726

Öz

Aim:

Our study aimed to evaluate patient satisfaction 12 weeks

after total knee arthroplasty (TKA) and determine preoperative and

postoperative factors which influence short term patient satisfac-

tion following TKA.

Material and Method:

Patients who underwent 40 primary TKAs

were included. Patients were assessed by using Western Ontario

and McMaster Universities Osteoarthritis Index (WOMAC), Short

Form-36 (SF36), Visual Analog Scale (VAS)-pain, 50-meter walk-

ing test preoperatively and 12 weeks after TKA. The duration of

walking was measured while the patients walked 50 m. Both pre

and postoperative flexion and extension range of motion (ROM) of

the knee were recorded. Postoperatively patient satisfaction was

evaluated.

Results:

Preoperatively, there was no difference between satis-

fied and dissatisfied patients in terms of age, VAS-pain, SF36

sub scores, WOMAC sub scores, active and passive flexion and

extension ROMs (p>0.05). Postoperatively, VAS-pain and SF36

general health and physical-emotional sub scores were lower

and passive knee flexion was higher in satisfied patient group

(p<0.05). Among clinical parameters, only postoperative VAS-

pain had a significant negative impact on patient satisfaction

(p<0.05). Other parameters including age, gender, pre and post-

operative active flexion and extension ROMs, preoperative VAS-

pain, WOMAC and 50-metre walking duration had no impact on

patient satisfaction (p>0.05).

Conclusion:

Preoperative pain, disability and quality of life

had no effect on postoperative short term patient satisfaction.

Postoperative pain severity, knee flexion ROM degree and de-

terioration in quality of life had significant negative impact on

postoperative patient satisfaction. Larger studies are necessary

to further clarify the factors associated with dissatisfaction fol-

lowing TKA.

Anahtar Kelimeler

arthroplasty; satisfaction; quality of life

Total Diz Artroplastisi Sonrası Hasta Memnuniyetini Etkileyen Preoperatif ve Postoperatif Faktörler

Öz

Amaç:

Bu çalışmada total diz artroplastisinden (TDA) 12 hafta

sonra hasta memnuniyetinin değerlendirilmesi ve TDA sonrası kısa

dönem hasta memnuniyetini etkileyen preoperatif ve postoperatif

faktörlerin saptanması amaçlanmıştır.

Materyal ve Metot:

Primer TDA yapılan 40 hasta çalışmaya alındı.

Hastalar Western Ontario ve Mc Masters Üniversiteleri Osteoartrit

İndeksi, Kısa Form-36 (SF36), Görsel Analog Skala (Visual Analog

Scale, VAS)-ağrı, 50 metre yürüme testi ile ameliyat öncesi ve

TDA’dan 12 hafta sonra değerlendirildi. Pre ve postoperatif diz

fleksiyon ve ekstansiyon eklem hareket açıklıkları (EHA) kaydedildi.

Postoperatif hasta memnuniyeti değerlendirildi.

Bulgular:

Preoperatif dönemde gruplar arasında memnun ve

memnun olmayan hastalar arasında yaş, VAS-ağrı, SF36 alt skorla-

rı, aktif ve pasif EHA’lar açısından fark yoktu (p>0,05). Postoperatif

dönemde memnun hasta grubunda VAS-ağrı ve SF36 genel sağlık

ve fiziksel-emosyonel rol alt skorları düşük, pasif diz fleksiyonu ise

yüksekti (p<0,05). Klinik parametreler arasında sadece postope-

ratif VAS-ağrının hasta memnuniyeti üzerine belirgin negatif etkisi

vardı (p<0,05). Yaş, cinsiyet, pre ve postoperatif aktif fleksiyon ve

ekstansiyon EHA’ları, preoperatif VAS-ağrı, WOMAC ve 50 metre

yürüme süresinin hasta memnuniyeti üzerine etkisi yoktu (p>0,05).

Sonuç:

Preoperatif ağrı, disabilite ve yaşam kalitesinin postoperatif

kısa dönem hasta memnuniyeti üzerine etkisi yoktu. Postoperatif dö

-

nemdeki ağrı şiddeti, diz fleksiyon EHA derecesi ve yaşam kalitesinde

bozulmanın hasta memnuniyeti üzerine belirgin negatif etkisi mevcut

-

tu. TDA sonrası memnuniyetsizlikle ilişkili faktörlerin geniş ölçüde net

-

leştirilmesi için daha çok hasta içeren çalışmalara gereksinim vardır.

Anahtar Kelimeler

artroplasti; memnuniyet; yaşam kalitesi

Kaynakça

• 1. Neogi T. The epidemiolog y and impact of pain in osteoarthritis. Osteoarthr Cartil 2013;21:1145–53.
• 2. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organization 2003;81:646–56.
• 3. Buckwalter JA, Saltzman C, Brown T. The impact of osteoarthritis: implications for research. Clinical Orthopaed Relat Res 2004;427:6–15.
• 4. Guilak F. Biomechanical factors in osteoarthritis. Best Pract Res ClinRheumatol 2011;25:815–23.
• 5. Choi YJ, Ra HJ. Patient Satisfaction after Total Knee Arthroplasty. Knee SurgRelat Res 2016;28:1–15.
• 6. Cuni B, Kutsal YG. Is Total Joint Replacement a Solution forPain in KneeOsteoarthritis? J PMR Sci 2014;17:99–106.
• 7. Hulka BS, Zyzanski SJ, Cassel JC, Thompson SJ. Scale for the measurement of attitudes toward physicians and primary medical care. MedCare 1970;8:429–36.
• 8. Lau RL, Gandhi R, Mahomed S, Mahomed N. Patient satisfaction after total knee and hip arthroplasty. Clin Geriatr Med 2012;28:349–65.
• 9. Janse AJ, Gemke RJ, Uiterwaal CS, van der Tweel I, Kimpen JL, Sinnema G. Quality of life: patients and doctors don’t always agree: a meta-analysis. J Clin Epidemiol 2004;57:653–61.
• 10. Harris IA, Harris AM, Naylor JM, Adie S, Mittal R, Dao AT. Discordance between patient and surgeon satisfaction after total jointarthroplasty. J Arthroplasty 2013;28:722–7.
• 11. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986;29:1039–49.
• 12. Tuzun EH, Eker L, Aytar A, Daskapan A, Bayramoglu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthr Cartil 2005;13:28–33.
• 13. Koçyiğit H, Aydemir O, Fişek G, Memiş A. Kısa form36(KF36)’nın Türkçe versiyonunun güvenilirliliği ve geçerliliği. İlaç ve Tedavi Derg 1995;12:102–6.
• 14. Price DD, McGrath PA, Rafii A, Buckhingham B. The validation of visual analog scales as ratio scale measures for chronic and experimental pain. Pain 1983;17:45–56.
• 15. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 2010;468:57–63.
• 16. Jacobs CA, Christensen CP. Factors influencing patient satisfaction two to five years after primary total knee arthroplasty. J Arthroplasty 2014;29:1189–91.
• 17. Dunbar MJ, Richardson G, Robertsson O. I can’t get no satisfaction after my total knee replacement: rhymes and reasons. Bone Joint J 2013;95-B(11 Suppl A):148–52.
• 18. Du H, Tang H, Gu J, Zhou YX. Patient satisfaction after posterior-stabilized total knee arthroplasty: A functional specific analysis. Theknee 2014;21:866–70.
• 19. Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 2006;452:35–43.
• 20. Williams DP, Price AJ, Beard DJ, Hadfield SG, Arden NK, Murray DW, et al. The effects of age on patient-reported outcome measures in total knee replacements. Bone Joint J 2013;95-B:38–44.
• 21. Singh JA, Gabriel S, Lewallen D. The impact of gender, age, and preoperative pain severity on pain after TKA. Clin Orthop Relat Res 2008;466(11):2717–23.
• 22. Kim TK, Chang CB, Kang YG, Kim SJ, Seong SC. Causes and predictors of patient’s satisfaction after uncomplicated total knee arthroplasty. J Arthroplasty 2009;24:263–71.
• 23. Thambiah MD, Nathan S, Seow BZ, Liang S, Lingaraj K. Patient satisfaction after total knee arthroplasty: an Asian perspective. Singapore Med J 2015;56:259–63.
• 24. Maratt JD, Lee Y, Lyman S, Westrich GH. Predictors of satisfaction following total knee arthroplasty. J Arthroplasty 2015;30:1142–5.
• 25. Gong L, Dong JY. Patient’s personality predicts recovery after total knee arthroplasty: a retrospective study. J Orthop Sci 2014;19:263–9.