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J Knee Surg 2021; 34(13): 1441-1445
DOI: 10.1055/s-0040-1710384
Original Article

Primary Total Knee Arthroplasty: Correlation between Preoperative Radiographic Severity of Arthritis and Postoperative Patient Satisfaction

Katie Rooks
1   Department of Orthopedic Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
,
Devon Houdek
2   Department of Medicine, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
,
Haron Obaid 
3   University of Saskatchewan, Medical Imaging, Saskatoon, Saskatchewan, Canada
,
William Dust
1   Department of Orthopedic Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Abstract

Predicting postoperative outcomes following total knee arthroplasty (TKA) is important for patient selection. This study focuses on patient-reported outcomes and satisfaction in relation to preoperative radiographic arthritis severity. A retrospective chart review of 420 TKAs was performed. Patient satisfaction was determined using a structured telephone survey with questions focused on degree of satisfaction whether they would have surgery again and their ability to kneel. The radiographic severity of the arthritis of the tibiofemoral joint was graded by a musculoskeletal radiologist using the Kellgren–Lawrence grading scale. The patellofemoral compartment was graded using the scale described by Jones et al. Those grouped as severe arthritis had an overall satisfaction rate of 96% (76% fully satisfied and 20% partially satisfied) compared with 82% of the time (64% fully satisfied and 18% partially satisfied) if their arthritis was mild. Postoperatively 51% of TKA patients were able to kneel. Univariate logistic regression showed an association between higher rates of satisfaction and male gender (p = 0.053), severity of preoperative radiographic arthritis (p = 0.034) those who would have surgery again (p ≤ 0.0001) and those able to kneel (p = 0.005). Patients should be informed preoperatively that if their arthritis is only mild radiographically, their outcomes are less predictable. There should also be a discussion surrounding kneeling and activities patients do, which may require kneeling, as many are unable to kneel postoperatively. The Level of Evidence for the study is III.

Keywords

knee - arthroplasty - satisfaction - kneeling - radiograph


Publication History

Received: 31 October 2019

Accepted: 21 March 2020

Article published online:
13 May 2020

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