Nearly one in five Ontario TKR patients not highly satisfied with their procedure

LAS VEGAS — Most patients who undergo total knee replacement (TKR) are satisfied with their surgery, but older patients and those who experienced the smallest change in WOMAC scores were less likely to be pleased with their procedure, according to a Canadian study presented at the American Academy of Orthopaedic Surgeons 76th Annual Meeting, here.

Robert B. Bourne, MD, of London, Ontario, and his colleagues reviewed a consecutive consort of 1,578 patients who had a TKR and consented to participate in the Ontario Joint Replacement Registry.

The researchers assessed patients preoperatively using the WOMAC scale and at 1 year postoperatively using the WOMAC scale, a patient satisfaction survey and questions regarding patients’ willingness to undergo surgery again. The investigators also performed a statistical analysis to identify factors that could be potentially predictive of patient dissatisfaction.

Approximately 90% of the respondents said they would have their TKR again, according to the abstract. Likewise, when the researchers used the Jaeschke satisfaction scale, about 90% of the respondents said they were “somewhat satisfied” with their procedure. But when Bourne and his colleagues investigated further, they found that only 78% of patients said they felt they were a good, great or a very great deal better than they were preoperatively, thanks to the procedure.

“In Ontario, about 81% of patients overall said they were truly pleased or satisfied with their TKR, which means that one out of every five patients isn’t highly satisfied with their procedure,” Bourne said. “That is something we are concerned about.”

They also said the most significant variables were the WOMAC change score, patient expectations from the surgery, and a complication, according to the abstract.

“We also found that patients who scored in the lowest quarter of patients in terms of their WOMAC score or who didn’t achieve a WOMAC change score of more than 25 of 100 points, as well as those who lived alone and/or had a complication, were more likely to be dissatisfied with their TKR,” Bourne said.

Older age also impacted patients’ satisfaction, he said. Patients older than 75 years old were more likely to express lower satisfaction scores, “but that could be a factor of the WOMAC score,” he said.

Reference:
Bourne RB, Chesworth BM, Davis AM. Patient satisfaction after TKR: Who is happy and who is not? Paper #156. Presented at the American Academy of Orthopaedic Surgeons 76th Annual Meeting. Feb. 25-28, 2009. Las Vegas.