Factors Contributing to Patient Satisfaction and Expectations following Computer-Assisted Total Knee Arthroplasty

Abstract The purpose of this study was to determine which factors contribute to patient satisfaction and expectations after total knee arthroplasty (TKA). A total of 109 patients (130 knees) with knee osteoarthritis who underwent primary TKA with navigation were studied. Intraoperative mediolateral laxity was measured. The factors including mediolateral laxity that affected patient satisfaction and expectations were evaluated using the 2011 Knee Society Score. Patient satisfaction after TKA correlated positively with symptoms and functional activities, and negatively with old age in univariate analysis. Multivariate analysis showed that symptoms and functional activities remained statistically significant; however, old age showed no difference. Patient expectations after TKA correlated positively with symptoms and functional activities, and negatively with mediolateral laxity at 60 degrees in univariate analysis. Multivariate analysis showed that symptoms, functional activities, and mediolateral laxity at 60 degrees remained statistically significant. In conclusion, midflexion instability was associated with worse expectations.

[1]  M. Ramappa.  Midflexion instability in primary total knee replacement: a review , 2015, SICOT-J.

[2]  Akihiro Sudo,et al.  Prediction of post-operative range of motion using intra-operative soft tissue balance in total knee arthroplasty with navigation , 2015, Computer aided surgery : official journal of the International Society for Computer Aided Surgery.

[3]  Y. Iwamoto,et al.  Correlations between patient satisfaction and ability to perform daily activities after total knee arthroplasty: why aren’t patients satisfied? , 2015, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[4]  S. Kirschner,et al.  Similar stability and range of motion between cruciate-retaining and cruciate-substituting ultracongruent insert total knee arthroplasty , 2015, Knee Surgery, Sports Traumatology, Arthroscopy.

[5]  Hiroaki Nakamura,et al.  Intraoperative assessment of midflexion laxity in total knee prosthesis. , 2014, The Knee.

[6]  J. Yang,et al.  In vivo gap analysis in various knee flexion angles during navigation-assisted total knee arthroplasty. , 2013, The Journal of arthroplasty.

[7]  M. Dunbar,et al.  I can't get no satisfaction after my total knee replacement: rhymes and reasons. , 2013, The bone & joint journal.

[8]  P. Baker,et al.  Patient satisfaction with total knee replacement cannot be predicted from pre-operative variables alone: A cohort study from the National Joint Registry for England and Wales. , 2013, The bone & joint journal.

[9]  J. Götz,et al.  Comparing navigation-based in vivo knee kinematics pre- and postoperatively between a cruciate-retaining and a cruciate-substituting implant , 2013, International Orthopaedics.

[10]  R. Barrack,et al.  Computer-assisted Total Knee Arthroplasty Is Currently of No Proven Clinical Benefit: A Systematic Review , 2013, Clinical orthopaedics and related research.

[11]  Y. Iwamoto,et al.  Postoperative Alignment and ROM Affect Patient Satisfaction After TKA , 2013, Clinical orthopaedics and related research.

[12]  P. Noble,et al.  The New Knee Society Knee Scoring System , 2012, Clinical orthopaedics and related research.

[13]  R. Becker,et al.  Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty , 2011, Knee Surgery, Sports Traumatology, Arthroscopy.

[14]  Philip C Noble,et al.  Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty? , 2011, The Journal of arthroplasty.

[15]  Lawrence Joseph,et al.  Imageless computer assisted versus conventional total knee replacement. A Bayesian meta-analysis of 23 comparative studies , 2011, International Orthopaedics.

[16]  O. Mahoney,et al.  Biomechanical influence of TKA designs with varying radii on bilateral TKA patients during sit-to-stand , 2008, Dynamic medicine : DM.

[17]  T. Fehring,et al.  Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. , 2007, The Journal of arthroplasty.

[18]  O. Mahoney,et al.  Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. , 2006, The Journal of arthroplasty.

[19]  Karon F Cook,et al.  The John Insall Award: Patient Expectations Affect Satisfaction with Total Knee Arthroplasty , 2006, Clinical orthopaedics and related research.

[20]  Brian S. Parsley,et al.  Posterior cruciate ligament substitution is not essential for excellent postoperative outcomes in total knee arthroplasty. , 2006, The Journal of arthroplasty.

[21]  Lutz Dürselen,et al.  Sagittal curvature of total knee replacements predicts in vivo kinematics , 2006 .

[22]  E. Cook,et al.  The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. , 2002, The Journal of rheumatology.

[23]  M. C. de Waal Malefijt,et al.  Patient satisfaction after total knee arthroplasty: a comparison between subjective and objective outcome assessments. , 2001, The Journal of arthroplasty.

[24]  Michael Dunbar,et al.  Patient satisfaction after knee arthroplasty: A report on 27,372 knees operated on between 1981 and 1995 in Sweden , 2000, Acta orthopaedica Scandinavica.

[25]  McGinty Jb.  Total knee arthroplasty. , 1997 .

[26]  L. Dorr,et al.  Rationale of the Knee Society clinical rating system. , 1989, Clinical orthopaedics and related research.

[27]  W. Walker.  Prosthesis , 1898, The American journal of dental science.