title: Measuring Outcomes: Pain and Quality of Life 48 Months After Acute Postoperative Total Knee Prosthetic Joint Infection.
abstract: BACKGROUND
  Measuring HRQOL is simple, inexpensive, permits the health status to be measured over time, and is useful to compare or initiate treatments and evaluate results, facilitating homogenization in patient inclusion.
  
  
  OBJECTIVE
  To evaluate disease-specific and generic HRQOL and influence of associated factors in patients undergoing open debridement for acute postsurgical knee prosthetic joint infection after TKR at 12 and 48 months after completing antibiotic treatment and considered cured of infection.
  
  
  METHODS
  Health-related quality-of-life measures were administered at baseline (WOMAC) and 12 and 48 months (WOMAC and SF-36) in patients with prosthesis retention, no symptoms of infection, and CRP (≤ 1 mg/dL).
  
  
  RESULTS
  Thirty patients were included, and 24 were evaluated at 48 months. WOMAC scores improved significantly (P < 0.01) at 12 and 48 months. The effect size was 0.72 for stiffness, 2.01 for pain, and 2.15 for function. At 48 months, improvements were greater (P < 0.02) except for stiffness. The most frequently isolated microorganisms were Staphylococcus aureus (14 patients) and coagulase-negative staphylococci (9 patients). SF-36 physical role, bodily pain, emotional role, and mental health dimension scores at 12 and 48 months were significantly worse in patients with isolates of Staphylococcus aureus (P < 0.05).
  
  
  CONCLUSIONS
  Health-related quality-of-life measures detected significant differences in outcomes in patients infected by S. aureus compared with patients infected by other microorganisms. HRQOL measures may provide useful complementary information on outcomes after acute postoperative infection.
authors.affiliation: Rheumatology Department, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic Universitari, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Núñez
authors.affiliation: Orthopedic Surgery Department, Hospital Clínic Universitari, Barcelona, Spain.
authors.forename: Felix
authors.initials: F
authors.lastname: Vilchez Cavazos
authors.affiliation: SAP Support al Diagnòstic i al Tractament, Institut Català de la Salut, Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Núñez Juarez
authors.affiliation: Orthopedic Surgery Department, Hospital Clínic Universitari, Barcelona, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Martinez-Pastor
authors.affiliation: Orthopedic Surgery Department, Hospital Clínic Universitari, Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Maculé Beneyto
authors.affiliation: Orthopedic Surgery Department, Hospital Clínic Universitari, Barcelona, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Suso
authors.affiliation: Infectious Diseases Department, Hospital Clínic Universitari, Barcelona, Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Soriano Viladomiu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000523:psychology / Q000639:trends; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D013211:Staphylococcus aureus; D013997:Time Factors; D016896:Treatment Outcome
keywords: TKA; arthroplasty; health-related quality of life; infection; knee; outcomes; postoperative pain