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. 2014 Jul 8;2(2):71-5.
doi: 10.11138/jts/2014.2.2.071. eCollection 2014 Apr-Jun.

Early assessment of patient perception of outcome in total knee replacement

Filippo Boniforti  1 , Antonio Macaione  1 , Stefano Gagliardi  1 , Francesco Giangrasso  1 , Davide DI Marzo  1 , Francesco Giacco  1
Affiliations

Early assessment of patient perception of outcome in total knee replacement

Filippo Boniforti et al. Joints. .

Abstract

Purpose: the aim of the present study was to measure patient perception in the early period after knee replacement surgery and to correlate health status with the surgery-related outcome.

Methods: thirty-eight consecutive patients who underwent total knee replacement were evaluated before surgery; at the time Radiographic evaluation was used to assess limb alignment and the Oxford Knee Score (OKS) to assess objective outcome. Health outcome was measured with the three-level version of the EuroQol - five dimension (EQ-5D-3L) self-administered questionnaire, a standardized instrument used to measure patient's perception of health status. Evaluation was performed before surgery, at discharge from hospital, and six weeks after surgery.

Results: the mean overall EQ-5D-3L scores were 10.23 before surgery, 8.34 at discharge from the hospital, and 6.52 at six weeks. The overall EQ-5D-3L score before surgery was greater than 8 points in 31 of the 38 patients, ranging from 5 to 8 points in 21 of the 38 patients at the discharge and greater than 8 points in six of the 38 patients six weeks after surgery. Patients with scores of over 8 points at six weeks also scored more than 10 points on the discharge assessment.

Conclusions: analysis of early patient reports of performance after TKR showed marked changes in the level of satisfaction during the first six weeks after surgery. An EQ-5D-3L score of 8 or more at follow-up should be considered a sign that the patient has not achieved satisfaction and, accordingly, should be studied in the context of a personalized follow-up schedule in order to identify as soon as possible the causes of impairment.

Level of evidence: Level IV, prognostic case series.

Keywords: arthroplasty; knee; perception; questionnaire; replacement.

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Figures

Fig. 1
Fig. 1
EQ-5D-3L overall levels for the five dimensions (histogram) and for health status (line).
Fig. 2
Fig. 2
The pre-operative EQ-5D-3L dimensions. A: The mean score on the descriptive system was 10.23 out of 15 points. B: The mean score on the visual analogue scale for health status (EQ VAS) was 6.1 out of 10 points.
Fig. 3
Fig. 3
The EQ-5D-3L dimensions at discharge. A: The mean score on the descriptive system was 8.34 out of 15 points. B: The mean score on the visual analogue scale for health status (EQ VAS) was 6.97 out of 10 points.
Fig. 4
Fig. 4
The EQ-5D-3L dimensions at 6 weeks. A: The mean score on the descriptive system was 6.52 out of 15 points. B: The mean score on the visual scale for health status (EQ VAS) was 8.13 out of 10 points.
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References

    1. Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ. The routine use of patient reported outcome measures in health-care settings. BMJ. 2010;340:c186. - PubMed
    1. Scott CE, Howie CR, MacDonald D, Biant LC. Predicting patient dissatisfaction following total knee replacement: a prospective study of 1217 cases. J Bone Joint Surg Br. 2010;92:1253–1258. - PubMed
    1. Beard DJ, Knezevic K, Al-Ali S, Dawson J, Price AJ. The use of outcome measures relating to the knee. Orthopaedics and Trauma. 2010;24:309–316.
    1. Judge A, Arden NK, Kiran A, et al. Interpretation of patient-reported outcomes for hip and knee replacement surgery: identification of thresholds associated with satisfaction with surgery. J Bone Joint Surg Br. 2012;94:412–418. - PubMed
    1. Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998;80:63–69. - PubMed