Nuisance symptoms after TJA had minimal impact on patient satisfaction
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Despite a high prevalence of self-reported nuisance symptoms after total joint arthroplasty, published results showed these symptoms had a minimal impact on overall patient satisfaction.
To determine the type of prevalence of TJA nuisance symptoms and impact on patient satisfaction at 1 year postoperatively, researchers analyzed survey responses from 545 patients who underwent either hip (39%) or knee (61%) arthroplasty. Occurrence of common nuisance symptoms and impact on overall satisfaction as rated by VAS score were determined by the survey.
total knee arthroplasty. Researchers also found the most commonly reported nuisance symptoms and associated impact on satisfaction among patients who underwent total hip arthroplasty included the limited ability to run/jump, thigh muscle pain and limp when walking. At 1 year, 94% of patients who underwent TKA and 88% of patients who underwent THA experienced at least one self-reported nuisance symptom, according to results. Researchers noted a mean satisfaction of 9 and 8.9 among patients who underwent TKA and THA, respectively.
“We are of the opinions that the inadequate preoperative address of nuisance symptoms can adversely influence postoperative satisfaction,” the authors wrote. “Preoperative patient educational programs should include information specific to the reported prevalence of nuisance symptoms and the limitations of arthroplasty in achieving expectations such as the postoperative possibility of experiencing crepitus, numbness, thigh pain, difficulty kneeling and the inability to run or jump. Furthermore, modification of current patient-reported outcome measures may be required to incorporate these nuisance-type symptoms.”
Perspective
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Jonathan R. Danoff, MD
The authors conducted a prospective study of 210 total hip and 335 total knee arthroplasty patients investigating the incidence of nuisance symptoms after surgery. They found that while the majority of patients can expect a high satisfaction with their overall outcome, 88% of the total hip arthroplasty patients and 94% of the total knee arthroplasty patients reported experiencing at least one persistent nuisance symptom persisting after 1 year. Total knee arthroplasty patients most commonly complained about difficulty in kneeling on the operative knee, while both cohorts of patients reported limitations when attempting to run or jump. Despite these nuisance symptoms, it is encouraging to note that the patients reported high overall satisfaction with their outcome, rating an average 9 of 10 on a VAS satisfaction scale. While these nuisance symptoms may not impair patient function or satisfaction with joint replacement surgery, it is important for orthopedic surgeons to set realistic patient expectations about potential residual symptoms or nuisance symptoms through preoperative patient education and counseling.
Northwell Health Orthopaedic Institute
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