Le score Oxford Knee et l’EQ-5d prédisent mal la satisfaction du patient après une arthroplastie totale du genou suivant un alignement mécanique : une étude transversale - 11/04/21

Oxford Knee Score And EQ-5d Poorly Predict Patient's Satisfaction Following Mechanically Aligned Total Knee Replacement: A Cross Sectional Study

Doi : 10.1016/j.rcot.2021.02.024

Advaith Gummaraju ^a,^⁎ , Cedric Maillot ^b, Kwaku Baryeh ^a, Loic Villet ^c, Charles Rivière ^c,^d,^e
^a South West London Elective Orthopaedic Centre, Dorking road, KT18 7EG Epsom, UK
^b Service de Chirurgie Orthopédique et Traumatologique Bichat-Beaujon, Assistance Publique des Hôpitaux de Paris, université Sorbonne, Paris, France
^c Centre de l’Arthrose–Clinique de Sport, 4, rue Georges Negrevergne, 33700 Mérignac, France
^d The MSK lab-Imperial College London, White City Campus, W12 0BZ London, UK
^e The Lister Hospital, Chelsea Bridge Rd, SW1W 8RH, London, UK

^⁎Auteur correspondant.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 11 April 2021
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Abstract

Background

Patient satisfaction is increasingly used to measure the success of arthroplasty. Satisfaction with the outcome of a total knee replacement (TKR) is traditionally thought to be associated with improvements in functional status and quality of life measures. This study aims to answer the following questions: 1. What is the level of patient satisfaction, improvement in knee function and patient quality of life associated with mechanically aligned TKR? 2. What is the relationship between OKS, EQ-5d scores and ‘outcome satisfaction’?

Hypothesis TKR is associated with a significant improvement in function, satisfaction and quality of life and that there is a strong correlation between OKS, EQ-5d and ‘outcome satisfaction’.

Method

Five thousand eight hundred and ninety six patients underwent primary TKR between January 2010 and December 2017 and had complete pre-operative and 2-year follow up data for OKS, EQ-5d and satisfaction scores. Outcomes data were collected prospectively and recorded on our institutional database. Minimal Clinically Important Difference (MCID) and the Patient Acceptable Symptomatic State (PASS) were calculated for OKS and EQ-5d, the association between OKS, EQ-5d and ‘outcome satisfaction was measured using regression analysis.

Results

The median 2-year ‘outcome satisfaction’ score was 90/100 with 79% of patients reporting excellent satisfaction (≥80/100) and 93.4% of patients satisfied (≥50/100). Post-operatively, median scores were 39 for OKS and 0.8 for EQ-5d. The mean increase in scores was 15.85 for OKS and 0.32 for EQ-5d. Satisfaction showed moderate positive correlation with post-operative OKS (r=0.69) and EQ-5D (0.58) scores but weaker correlation with the change in OKS (r=0.57) and EQ-5d(r=0.32) scores from pre-operative levels.

Discussion/Conclusion

Mechanically aligned TKR is overall a successful operation responsible of fair rate of patient satisfaction. OKS and EQ-5d are imperfect predictors for satisfaction as they are significantly influenced by patients’ comorbidities. This should be taken into account when evaluating the success of an operation.

Level of evidence

IIc; Observational study (based on prospectively collected data from an institutional registry).

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Keywords : Total knee replacement, Satisfaction, Function, Quality of life, PROMS, OKS

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.