2017 ISAKOS Biennial Congress Paper #170

 

What Makes Patients Of TKR Unhappy? A Study of Subjective Patient Satisfaction

Kailas D. Patil, MD, Pune, Maharastra INDIA
Parag Sancheti, FRCS (Ed),MS(ORTH), DNB(ORTH), MCh(UK),Ph.D(UK), Pune, Maharashtra INDIA
Atul Ashok Patil, MS (Orth), Pune, Maharashtra INDIA
Ashok Kumar Shyam, M. Orthopaedics, Pune, Maharashtra INDIA

Sancheti institute for Orthopaedics and rehabilitation, PUNE, MAHARASHTRA, INDIA

FDA Status Not Applicable

Summary

There are multiple reasons which cause dissatisfaction among thepatients being operated for TKA, most important of which are related to pain,stiffness and difficulty in performing daily activities

Abstract

Introduction

The outcome measures differ for clinician and patients, making patient satisfaction as an important outcome measure. It is also important to note specific reasons for dissatisfaction among the patients. We analysed patients that were not satisfied after TKR to find specific functional activities that limited them

Methods

920 cases of total knee replacement with 2 years follow up were assessed. We excluded patients with revision arthroplasties and those with an old intra-articular fracture. Patient satisfaction was graded on a 5-point Likert scale. 90 Unsatisfied patients were further analysed for pain, stiffness and difficulty in performing daily activities by studying their individual responses to WOMAC questions.

Results

Majority of unsatisfied patients were those who had difficulty in performing routine activities of daily living (ADL). 90 percent patients had pain mainly while climbing up and down the stairs while only 15-20 percent patients had pain while walking on flat Surface, sitting or lying on bed, or in standing positions. Around 10-12 percent patient had stiffness i.e. lower ranges of motion than they had expected.

Conclusions

There are multiple reasons which cause dissatisfaction among thepatients being operated for TKA, most important of which are related to pain,stiffness and difficulty in performing daily activities. Knowledge of these factors willhelp surgeons to provide better preoperative counselling to patients