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The rate and predictors of patient satisfaction after total knee arthroplasty are influenced by the focus of the question.

Abstract Aims The primary aim of this study was to assess the rate of patient satisfaction one year after total knee arthroplasty (TKA) according to the focus of the question asked. The secondary aims were to identify independent predictors of patient satisfaction according to the focus of the question. Patients and Methods A retrospective cohort of 2521 patients undergoing a primary unilateral TKA were identified from an established regional arthroplasty database. Patient demographics, comorbidities, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 12-Item Short-Form Health Survey (SF-12) scores were collected preoperatively and one year postoperatively. Patient satisfaction was assessed using four questions, which focused on overall outcome, activity, work, and pain. Logistic regression analysis was used to identify independent preoperative predictors of increased stiffness when adjusting for confounding variables. Results Using patient satisfaction with the overall outcome (n = 2265, 89.8%) as the standard, there was no difference in the rate of satisfaction for pain relief (n = 2277, odds ratio (OR) 0.95, 95% confident intervals (CI) 0.79 to 1.14, p = 0.60), but patients were more likely to be dissatisfied with activities (79.3%, n = 2000/2521, OR 2.22, 95% CI 1.96 to 2.70, p < 0.001) and work (85.8%, n = 2163/2521, OR 1.47, 95% CI 1.23 to 1.75, p < 0.001). Logistic regression analysis identified different predictors of satisfaction for each of the focused satisfaction questions. Overall satisfaction was influenced by diabetes (p = 0.03), depression (p = 0.004), back pain (p < 0.001), and SF-12 physical (p = 0.008) and mental (p = 0.01) components. Satisfaction with activities was influenced by depression (p = 0.001), back pain (p < 0.001), WOMAC stiffness score (p = 0.03), and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with work was influenced by depression (p = 0.007), back pain (p < 0.001), WOMAC function (p = 0.04) and stiffness (p = 0.05) scores, and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with pain relief was influenced by diabetes (p < 0.001), back pain (p < 0.001), and SF-12 mental component (p = 0.04). Conclusion The focus of the satisfaction question significantly influences the rate and the predictors of patient satisfaction after TKA. Cite this article: Bone Joint J 2018;100-B:740-8.
PMID
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Authors

Mayor MeshTerms
Keywords

Outcome

Predictors

Satisfaction

Total knee arthroplasty

WOMAC

Journal Title the bone & joint journal
Publication Year Start




PMID- 29855236
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180612
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 6
DP  - 2018 Jun 1
TI  - The rate and predictors of patient satisfaction after total knee arthroplasty are
      influenced by the focus of the question.
PG  - 740-748
LID - 10.1302/0301-620X.100B6.BJJ-2017-1292.R1 [doi]
AB  - Aims The primary aim of this study was to assess the rate of patient satisfaction
      one year after total knee arthroplasty (TKA) according to the focus of the
      question asked. The secondary aims were to identify independent predictors of
      patient satisfaction according to the focus of the question. Patients and Methods
      A retrospective cohort of 2521 patients undergoing a primary unilateral TKA were 
      identified from an established regional arthroplasty database. Patient
      demographics, comorbidities, Western Ontario and McMaster Universities
      Osteoarthritis Index (WOMAC) and 12-Item Short-Form Health Survey (SF-12) scores 
      were collected preoperatively and one year postoperatively. Patient satisfaction 
      was assessed using four questions, which focused on overall outcome, activity,
      work, and pain. Logistic regression analysis was used to identify independent
      preoperative predictors of increased stiffness when adjusting for confounding
      variables. Results Using patient satisfaction with the overall outcome (n = 2265,
      89.8%) as the standard, there was no difference in the rate of satisfaction for
      pain relief (n = 2277, odds ratio (OR) 0.95, 95% confident intervals (CI) 0.79 to
      1.14, p = 0.60), but patients were more likely to be dissatisfied with activities
      (79.3%, n = 2000/2521, OR 2.22, 95% CI 1.96 to 2.70, p &lt; 0.001) and work (85.8%, 
      n = 2163/2521, OR 1.47, 95% CI 1.23 to 1.75, p &lt; 0.001). Logistic regression
      analysis identified different predictors of satisfaction for each of the focused 
      satisfaction questions. Overall satisfaction was influenced by diabetes (p =
      0.03), depression (p = 0.004), back pain (p &lt; 0.001), and SF-12 physical (p =
      0.008) and mental (p = 0.01) components. Satisfaction with activities was
      influenced by depression (p = 0.001), back pain (p &lt; 0.001), WOMAC stiffness
      score (p = 0.03), and SF-12 physical (p &lt; 0.001) and mental (p &lt; 0.001)
      components. Satisfaction with work was influenced by depression (p = 0.007), back
      pain (p &lt; 0.001), WOMAC function (p = 0.04) and stiffness (p = 0.05) scores, and 
      SF-12 physical (p &lt; 0.001) and mental (p &lt; 0.001) components. Satisfaction with
      pain relief was influenced by diabetes (p &lt; 0.001), back pain (p &lt; 0.001), and
      SF-12 mental component (p = 0.04). Conclusion The focus of the satisfaction
      question significantly influences the rate and the predictors of patient
      satisfaction after TKA. Cite this article: Bone Joint J 2018;100-B:740-8.
FAU - Clement, N D
AU  - Clement ND
AD  - Department of Orthopaedics, Freeman Hospital, Newcastle-upon-Tyne, UK.
FAU - Bardgett, M
AU  - Bardgett M
AD  - Department of Orthopaedics, Freeman Hospital, Newcastle-upon-Tyne, UK.
FAU - Weir, D
AU  - Weir D
AD  - Department of Orthopaedics, Freeman Hospital, Newcastle-upon-Tyne, UK.
FAU - Holland, J
AU  - Holland J
AD  - Department of Orthopaedics, Freeman Hospital, Newcastle-upon-Tyne, UK.
FAU - Gerrand, C
AU  - Gerrand C
AD  - Royal National Orthopaedic Hospital, Stanmore, UK.
FAU - Deehan, D J
AU  - Deehan DJ
AD  - Department of Orthopaedics, Freeman Hospital, Newcastle-upon-Tyne, UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone &amp; joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Aged
MH  - Arthroplasty, Replacement, Knee/*methods
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Knee Joint/surgery
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Knee/*surgery
MH  - Pain Management
MH  - Patient Satisfaction/*statistics &amp; numerical data
MH  - Quality of Life
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Outcome
OT  - Predictors
OT  - Satisfaction
OT  - Total knee arthroplasty
OT  - WOMAC
EDAT- 2018/06/02 06:00
MHDA- 2018/06/13 06:00
CRDT- 2018/06/02 06:00
PHST- 2018/06/02 06:00 [entrez]
PHST- 2018/06/02 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
AID - 10.1302/0301-620X.100B6.BJJ-2017-1292.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jun 1;100-B(6):740-748. doi:
      10.1302/0301-620X.100B6.BJJ-2017-1292.R1.