2015 ISAKOS Biennial Congress ePoster #1426

Subjective Evaluations of Both Before and After Total Knee Arthroplasty with the 2011 Knee Society Score

Atsuo Uefuji, MD, Kobe, Hyogo JAPAN
Tomoyuki Matsumoto, MD, PhD, Kobe, Hyogo JAPAN
Koji Takayama, MD, PhD, Kobe, Hyogo JAPAN
Yuichi Kuroda, MD, Kobe JAPAN
Kazunari Ishida, MD, PhD, Kobe, Hyogo JAPAN
Naoki Nakano, MD, Kobe, Hyogo JAPAN
Kanto Nagai, MD, PhD, Kobe, Hyogo JAPAN
Daisuke Araki, MD, PhD, Kobe, Hyogo JAPAN
Takehiko Matsushita, MD, Kobe, Hyogo JAPAN
Ryosuke Kuroda, MD, PhD, Kobe, Hyogo JAPAN
Masahiro Kurosaka, MD, Kobe, Hyogo JAPAN

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, JAPAN

FDA Status Not Applicable

Summary: Using 2011KSS the subjective scoring system including 4aspects postoperative patient expectation score decreased compared to preoperative score despite all other scores increased. Postoperative objective knee indicator, patient satisfaction score and functional activity score had correlations with preoperative functional activity score. Each postoperative aspect had correlations with other aspects

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Abstract:

Purpose

With the use of traditional objective scoring system, many reports showed good clinical results in aspects of alignment, stability, pain relief and function after total knee arthroplasty (TKA). However, some reports showed that there were poor correlations between subjective and objective clinical scores in TKA. The 2011 Knee Society Score (the 2011 KSS) was developed to quantify the subjective clinical scores, satisfaction, expectations and physical activities of patients. And there was no report about the comparison between pre and postoperative subjective clinical scores using the 2011 KSS. In this study, we compared the subjective clinical scores using the 2011 KSS, between preoperatively and 6 month postoperatively in TKA.

Materials And Methods

Fifty-four knees of 52 patients (73.7 ± 7.6 years old) undergoing TKA from May 2012 to December 2013 using the 2011 KSS were included in the study. There were 50 osteoarthritis knees and 4 rheumatic knees. The aspects of the 2011 KSS were objective knee indicator, patient satisfaction score, patient expectation score, and functional activity score.
We evaluated each aspect between preoperatively and postoperatively, assessed the correlations between preoperative and postoperative aspects, and assessed the correlations among postoperative aspects.

Results

Postoperative objective knee indicator, patient satisfaction score, and functional activity score were significantly higher compared to preoperative scores respectively.

Objective

knee indicator: 90.3 vs 65.3, patient satisfaction score 22.4 vs 14.4, functional activity score 63.9 vs 44.8, post vs preoperative score, respectively, p<0.001 ) However, postoperative patient expectation score was significantly lower compared to preoperative score (10.3 vs 12.3, post vs preoperative scores, p<0.001)
Postoperative objective knee indicator, patient satisfaction score and functional activity score had positive correlations with preoperative functional activity score (p=0.007, p=0.024, and p<0.001 respectively). And postoperative patient expectation score had no correlations with other aspects of preoperative scores.
All scores of postoperative aspects had correlations with each other

Objective

knee indicator-patient satisfaction score, p<0.001. objective knee indicator-patient expectation score, p=0.005. objective knee indicator-functional activity score, p<0.001. patient satisfaction score- patient expectation score, p<0.001. patient satisfaction score- functional activity score p<0.001. patient expectation score - functional activity score, p<0.001.)

Discussion

The result of the 2011 KSS at 6 months after TKA indicated that patient expectation scores decreased compared to preoperative scores despite of all the other scores increased, suggesting that more detailed informed consent explaining postoperative knee pain, condition, function, and activity et al. should be done before surgery.
Postoperative objective knee indicator, patient satisfaction score and functional activity score had correlations with preoperative functional activity score, indicating that encouraging preoperative functional activity had the possibility to achieve the successful outcome of TKA.
Since each postoperative score of 2011 KSS aspect had correlations with scores of the other aspects, the all evaluation aspects seem to influence each other. The part of postoperative physician derived score might have correlation with patient derived score.