In this month’s journal review…

Which Patients Are Satisfied With Their Overall Outcome but Dissatisfied With Their Return to Recreational Activities After Total Knee Arthroplasty?

Clement, N.D. , Walker, L.C., et al The Knee November 2018

DOI: 10.1016/j.knee.2018.09.013

Background

In this month’s journal of The Knee a study was performed to assess with the patient is dissatisfied with both recreational activities and overall outcome were different to those dissatisfied with recreational activities but satisfied with her overall outcome 1 year after total knee arthroplasty.

Methods

The authors looked at 3324 primary total knee replacements.  They evaluated the patient’s preoperatively and 1 year postop.  Overall patient satisfaction with recreational activities was assessed at 1 year after surgery.

Younger patients have increased expectations of return to sport activities but only about half return to their preferred physical activity after total knee arthroplasty.  The reported satisfaction rate after total knee arthroplasty varies between 75 and 97%.  Multiple factors are identified to influence the rate of overall satisfaction after total knee replacement.  It was reported that depression, back pain and overall general physical and mental health work, independent factors of the rate of satisfaction with recreational activities and overall satisfaction after total knee arthroplasty.  The goal of this study was to assess whether patients dissatisfied with recreational activities and overall outcome were different to those dissatisfied with both overall and recreational activities 1 year after total knee arthroplasty.  The authors also try to evaluate for independent predictors of satisfaction.

Results

The study demonstrated that the satisfaction with improving ability to perform recreational activities 1 year after total knee arthroplasty was significantly lower than the observed rate for overall satisfaction.  Comorbidities of depression, back pain, less preoperative symptoms of stiffness and worse general overall physical and mental health where independent predictors of dissatisfaction with ability to perform recreational activities after total knee arthroplasty.  Patients of older age, greater BMI (obesity) and without hypertension or more likely to be dissatisfied with her ability to perform recreational activities despite being satisfied with her overall outcome.

The study did not determine whether the patient’s dissatisfaction with their ability to return to these activities was a result of their other associated health conditions or limitations of the total knee arthroplasty.  This analysis of patient satisfaction was performed at 1 year after total knee arthroplasty.  Therefore, potentially some of the patient’s perception of their function may improve over time and their level of satisfaction may change.

Conclusion

In conclusion, patients of older age and higher body mass index and without hypertension or more likely to be dissatisfied with recreational activities despite being satisfied with her overall outcome.

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