Higher treatment effect after total knee arthroplasty is associated with higher patient satisfaction
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KNEE
Higher treatment effect after total knee arthroplasty is associated with higher patient satisfaction Jörg Lützner1 · Franziska Beyer1 · Klaus‑Peter Günther1 · Jörg Huber2 Received: 1 July 2020 / Accepted: 1 September 2020 © The Author(s) 2020
Abstract Purpose The aim of this study was to investigate what influence the treatment effect after total knee arthroplasty (TKA) had on patient satisfaction. Methods Prospective registry data of a University-based arthroplasty centre were used. 582 patients with unilateral bicondylar TKA were analyzed. Treatment effect (TE) was deduced from Oxford Knee Score (OKS) before and one year after surgery. Positive values correspond to improved symptoms (maximum 1.0 reflect no symptoms at all) and negative values correspond to deterioration of symptoms. Satisfaction on a visual-analogue scale from 0 to 10 and the willingness to undergo TKA surgery again was assessed one year after surgery. Results The mean OKS improved from 22.1 before to 36.7 one year after TKA. Treatment effects ranged from 1.0 to –0.62 with a mean TE of 0.56. Taking an individual treatment effect of 0.2 as a cut-off between responder and non-responder, a total of 85.8% would be classified as responder after TKA. The mean satisfaction score with the TKA was 8.1. There was a significant correlation between the individual treatment effect and satisfaction after TKA (p 0.95), good (TE > 0.50–95), moderate (TE > 0.2–0.5), unchanged (TE – 0.2 to 0.2) and worse (TE 0.2 corresponds to validated responder criteria [16]. Therefore, patients with a TE > 0.2 have been considered as responders and patients with a TE ≤ 0.2 as non-responders.
Knee Surgery, Sports Traumatology, Arthroscopy
At the one-year follow-up, patients were asked about their satisfaction with TKA surgery on a visual analogue scale from 0 (very dissatisfied) to 10.0 (very satisfied). Additionally, patients were asked if they would undergo TKA surgery again, if necessary. They were given five options to answer: definitely yes, likely, uncertain, unlikely, definitely no. Patient characteristics, data from the surgery, comorbidities (ASA grade), and adverse events were recorded prospectively and together with the questionnaires assembled in the registry. The study has been performed in compliance with the Helsinki Declaration and has been approved by the local ethics committee (EK135042014). All patients signed an informed consent.
Statistical analysis To detect a clinically relevant difference between responder and non-responder based on two grades on the satisfaction VAS with a standard deviation of 2.0, a power of 80% and p 0.2–0.5, unchanged – 0.2 to 0.2, worse 0.95, good > 0.5–0.95, moderate > 0.2–0.5, unchanged – 0.2 to 0.2, worse
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