Patient dissatisfaction following total knee replacement: a growing concern?
A national, multi-centre study was designed in which a questionnaire quantifying the degree of patient satisfaction and residual symptoms in patients following total knee replacement (TKR) was administered by an independent, blinded third party survey centre. A total of 90% of patients reported satisfaction with the overall functioning of their knee, but 66% felt their knee to be 'normal', with the reported incidence of residual symptoms and functional problems ranging from 33% to 54%. Female patients and patients from low-income households had increased odds of reporting dissatisfaction. Neither the use of contemporary implant designs (gender-specific, high-flex, rotating platform) or custom cutting guides (CCG) with a neutral mechanical axis target improved patient-perceived outcomes. However, use of a CCG to perform a so-called kinematically aligned TKR showed a trend towards more patients reporting their knee to feel 'normal' when compared with a so called mechanically aligned TKR This data shows a degree of dissatisfaction and residual symptoms following TKR, and that several recent modifications in implant design and surgical technique have not improved the current situation.
Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, 660 S. Euclid Ave., Campus Box 8233, St. Louis, Missouri, USA.
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Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, 660 S. Euclid Ave., Campus Box 8233, St. Louis, Missouri, USA.
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Nunley
Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, 660 S. Euclid Ave., Campus Box 8233, St. Louis, Missouri, USA.
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Barrack
D000293:Adolescent; D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D011795:Surveys and Questionnaires; D055815:Young Adult
Outcomes; Knee replacement; Patient satisfaction; Total knee arthroplasty