title: Early assessment of patient perception of outcome in total knee replacement.
abstract: OBJECTIVE
  the aim of the present study was to measure patient perception in the early period after knee replacement surgery and to correlate health status with the surgery-related outcome.
  
  
  METHODS
  thirty-eight consecutive patients who underwent total knee replacement were evaluated before surgery; at the time Radiographic evaluation was used to assess limb alignment and the Oxford Knee Score (OKS) to assess objective outcome. Health outcome was measured with the three-level version of the EuroQol - five dimension (EQ-5D-3L) self-administered questionnaire, a standardized instrument used to measure patient's perception of health status. Evaluation was performed before surgery, at discharge from hospital, and six weeks after surgery.
  
  
  RESULTS
  the mean overall EQ-5D-3L scores were 10.23 before surgery, 8.34 at discharge from the hospital, and 6.52 at six weeks. The overall EQ-5D-3L score before surgery was greater than 8 points in 31 of the 38 patients, ranging from 5 to 8 points in 21 of the 38 patients at the discharge and greater than 8 points in six of the 38 patients six weeks after surgery. Patients with scores of over 8 points at six weeks also scored more than 10 points on the discharge assessment.
  
  
  CONCLUSIONS
  analysis of early patient reports of performance after TKR showed marked changes in the level of satisfaction during the first six weeks after surgery. An EQ-5D-3L score of 8 or more at follow-up should be considered a sign that the patient has not achieved satisfaction and, accordingly, should be studied in the context of a personalized follow-up schedule in order to identify as soon as possible the causes of impairment.
  
  
  METHODS
  Level IV, prognostic case series.
authors.affiliation: Department of Orthopaedics, San raffaele G. Giglio Foundation, Cefalù, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Boniforti
authors.affiliation: Department of Orthopaedics, San raffaele G. Giglio Foundation, Cefalù, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Macaione
authors.affiliation: Department of Orthopaedics, San raffaele G. Giglio Foundation, Cefalù, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Gagliardi
authors.affiliation: Department of Orthopaedics, San raffaele G. Giglio Foundation, Cefalù, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giangrasso
authors.affiliation: Department of Orthopaedics, San raffaele G. Giglio Foundation, Cefalù, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: DI Marzo
authors.affiliation: Department of Orthopaedics, San raffaele G. Giglio Foundation, Cefalù, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giacco
keywords: arthroplasty; knee; perception; questionnaire; replacement