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. 2018 Jul-Aug;52(4):387-392.
doi: 10.4103/ortho.IJOrtho_359_16.

Does the Surgeon-reported Outcome Correlate with Patient-reported Outcome after Total Knee Arthroplasty? A Cohort Study

Sivashanmugam Raju  1   2 , Karthikeyan Chinnakkannu  3 , Ashok Selvaraj  4 , Balasubramanian Balakumar  5 , Mohan K Puttaswamy  6 , P V Jayasankar  2
Affiliations

Does the Surgeon-reported Outcome Correlate with Patient-reported Outcome after Total Knee Arthroplasty? A Cohort Study

Sivashanmugam Raju et al. Indian J Orthop. 2018 Jul-Aug.

Abstract

Background: Total knee arthroplasty (TKA) has been proved to be a successful and cost-effective treatment for improving pain and function in patients with knee arthritis. Total knee arthroplasty (TKA) is one of the most common orthopaedic surgeries performed worldwide and advancement in surgical techniques and prosthetic designs have improved the patient outcomes. However, concerns and priorities of patients and surgeons relating to joint replacement may differ.

Materials and methods: 306 TKAs in 223 patients were evaluated for functional outcome using surgeon reported American Knee Society Knee Score (KS)/Functional Score (FS) and patient-reported Oxford Knee Score (OKS). We have also assessed the correlation between FS and OKS at midterm follow up.

Results: The mean preoperative KS, FS, and OKS in 223 patients were 42.76, 42.4, and 38.84 and the midterm mean KS, FS, and OKS were 84.29, 73.40, and 30.26, respectively. There was a statistically significant improvement in the KS, FS, and OKS at midterm follow up in Category A (CAT A) (bilateral TKA or unilateral with asymptomatic contralateral knee), CAT B (unilateral TKA with symptomatic other knee) and CAT C (inflammatory arthritis). Overall, the correlation between the midterm FS and OKS was fair. However, in CAT A and CAT B, there was no significant correlation between FS and OKS, but CAT C had a strong correlation. There was a statistically significant improvement in the KS, FS, and OKS when midterm follow up scores were compared with preoperative scores. However, no significant correlation between the American knee society FS and OKS in osteoarthritic patients at midterm follow up signifies acceptable outcome may vary between patients and physicians.

Conclusion: All patients should be counseled preoperatively to assess their expectations and sensitize them to information regarding the expected functional outcome following TKA in their cultural context.

Keywords: Americal knee society knee score; Indian; Oxford knee score; Prosthesis implantation; arthroplasty; functional score; knee; osteoarthritis; outcome and process assessment (health care); replacement.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
A bar diagram showing the preoperative and midterm follow up American Knee Society Knee Score (KS), Functional Score (FS) and Oxford Knee Score (OKS) (Note: In OKS, high score implies poor function and vice versa)
Figure 2
Figure 2
A bar diagram showing the preoperative and midterm follow up scores for the three Categories A, B and C. (Note: In OKS, high score implies poor function and vice versa)
Figure 3
Figure 3
Scatter plot depicting no significant correlation between midterm FS and OKS in CAT A
Figure 4
Figure 4
Scatter plot depicting no significant correlation between midterm FS and OKS in CAT B
Figure 5
Figure 5
Scatter plot depicting a strong correlation between midterm FS and OKS in CAT C
See this image and copyright information in PMC

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