Dissatisfied patients after total knee arthroplasty: a registry study involving 114 patients with 8-13 years of followup.
OBJECTIVE
In 2003, an enquiry by the Swedish Knee Arthroplasty Register (SKAR) 2-7 years after total knee arthroplasty (TKA) revealed patients who were dissatisfied with the outcome of their surgery but who had not been revised. 6 years later, we examined the dissatisfied patients in one Swedish county and a matched group of very satisfied patients.


METHODS
118 TKAs in 114 patients, all of whom had had their surgery between 1996 and 2001, were examined in 2009-2010. 55 patients (with 58 TKAs) had stated in 2003 that they were dissatisfied with their knees and 59 (with 60 TKAs) had stated that they were very satisfied with their knees. The patients were examined clinically and radiographically, and performed functional tests consisting of the 6-minute walk and chair-stand test. All the patients filled out a visual analog scale (VAS, 0-100 mm) regarding knee pain and also the Hospital and Anxiety and Depression scale (HAD).


RESULTS
Mean VAS score for knee pain differed by 30 mm in favor of the very satisfied group (p < 0.001). 23 of the 55 patients in the dissatisfied group and 6 of 59 patients in the very satisfied group suffered from anxiety and/or depression (p = 0.001). Mean range of motion was 11 degrees better in the very satisfied group (p < 0.001). The groups were similar with regard to clinical examination, physical performance testing, and radiography.


CONCLUSIONS
The patients who reported poor response after TKA continued to be unhappy after 8-13 years, as demonstrated by VAS pain and HAD, despite the absence of a discernible objective reason for revision.
Department of Orthopedics , Clinical Sciences, and the Swedish Knee Arthroplasty Register , Lund University and Skåne University Hospital.
Abdulemir
A
Ali
Martin
M
Sundberg
Otto
O
Robertsson
Leif E
LE
Dahlberg
Carina A
CA
Thorstensson
Inga
I
Redlund-Johnell
Ingvar
I
Kristiansson
Anders
A
Lindstrand
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D020370:Osteoarthritis, Knee / Q000523:psychology* / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012042:Registries; D012107:Research Design; D012189:Retrospective Studies; D016896:Treatment Outcome