DOI: https://doi.org/10.22263/2312-4156.2017.5.75
Balaboshka K.B., Khadzkou Y.K.
The analysis of the early total knee joint arthroplasty results
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2017;16(5):75-83.
Abstract.
Objectives. To identify and evaluate the factors affecting the outcome of the total knee replacement (TKR) on the basis of the study and analysis of the early results of surgical treatment forgonarthrosisin the clinicof traumatology, orthopedics and military surgery stationed in Vitebsk Regional Clinical Hospital.
Material and methods. The study included 134 patients who had undergone TKR for the 3rd – the 4th stages of gonarthrosis. Patients with the presence of valgus/varus deformity of the knee joint which was more than 10° were included in a separate group. Patients were examined by means of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires and the Self-administered patient satisfaction scale. The average follow-up period made up 8,1 (+/-) months.
Results. The overall average score according to WOMAC before the operation was 26,8±5,8, after it – 73,2±7,8. Permanent pain syndrome was noted in 7 (5,2%) patients, 23 (17,2%) patients suffered from periodical pain in the joint area. According to the results of our study with the use of the Self-administered patient satisfaction scale intended for the evaluation of the outcome of surgical treatment, 83,8% of patients rated the immediate outcome of the operation as either «excellent» or «good», 12,5% as «satisfactory» and 3,8% of them as «bad». Intergroup differences on the analysis of the results of the study were not revealed.
Conclusions. TKR allows to achieve positive results of treatment in the majority of patients. The degree of preoperative deformation of the limb axis does not have any significant effect on patients satisfaction with the results of surgical treatment in the early postoperative period. The reserve for improving the results of TKR is seen both in the improvement of perioperative maintenance and in the increase of pre- and post-operative awareness of patients.
Key words: osteoarthritis, knee replacement, rehabilitation, functional outcome.
References
1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007 Apr;89(4):780-5. doi: 10.2106/JBJS.F.00222
2. Singh JA, Vessely MB, Harmsen WS, Schleck CD, Melton LJ, Kurland RL, et al. A population-based study of trends in the use of total hip and total knee arthroplasty, 1969-2008. Mayo Clin Proc. 2010 Oct;85(10):898-904. doi: http://dx.doi.org/10.4065/mcp.2010.0115
3. Zanasi S. Innovations in total knee replacement: new trends in operative treatment and changes in peri-operative management. Eur Orthop Traumatol. 2011 Jul;2(1-2):21-31. doi: http://dx.doi.org/10.1007/s12570-011-0066-6
4. Choi YJ, Ra HJ. Patient Satisfaction after Total Knee Arthroplasty. Knee Surg Relat Res. 2016 Mar;28(1):1-15. doi: http://dx.doi.org/10.5792/ksrr.2016.28.1.1
5. Baker PN, van der Meulen JH, Lewsey J, Gregg PJ. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg Br. 2007 Jul;89(7):893-900.
6. Mulcahy H, Chew FS. Current concepts in knee replacement: complications. AJR Am J Roentgenol. 2014 Jan;202(1):W76-86. doi: http://dx.doi.org/10.2214/AJR.13.11308
7. Khod'kov EK, Boloboshko KB. A role of a vacuum drainage at endoprosthesis replacement of a knee joint. Vestn VGMU. 2017;16(4):73-80. (In Russ.)
8. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010 Jan;468(1):57-63. doi: http://dx.doi.org/10.1007/s11999-009-1119-9
9. Mohamed N, Gandhi R, Daltroy L, Katz JN. The self-administered patient satisfaction scale for primary hip and knee arthroplasty. Arthritis. 2011;2011. Article ID 591253. doi: http://dx.doi.org/10.1155/2011/591253
10. Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012 Feb;2(1):e000435. doi: http://dx.doi.org/10.1136/bmjopen-2011-000435
11. Graham B, Green A, James M, Katz J, Swiontkowski M. Measuring patient satisfaction in orthopaedic surgery. J Bone Joint Surg Am. 2015 Jan;97(1):80-4. doi: http://dx.doi.org/10.2106/JBJS.N.00811
12. Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000 Jun;71(3):262-7. doi: http://dx.doi.org/10.1080/000164700317411852
Information about authors:
Balaboshka K.B. – Candidate of Medical Sciences, associate professor, head of the Chair of Traumatology, Orthopedics & Military Surgery, Vitebsk State Order of Peoples’ Friendship Medical University;
Khadzkou Y.K. – teacher-trainee of the Chair of Traumatology, Orthopedics & Military Surgery, Vitebsk State Order of Peoples’ Friendship Medical University.
Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Traumatology, Orthopedics & Military Surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yauheni K. Khadzkou.
