Measuring tools for functional outcomes in total knee arthroplasty.

London Health Sciences Centre, University of Western Ontario, University Campus, London, ON, Canada.
Clinical Orthopaedics and Related Research (Impact Factor: 2.79). 10/2008; 466(11):2634-8. DOI: 10.1007/s11999-008-0468-0
Source: PubMed

ABSTRACT Total knee arthroplasty has come under increasing scrutiny attributable to the fact that it is a high-volume, high-cost medical intervention in an era of increasingly scarce medical resources. Health-related quality-of-life outcomes have been developed such that healthcare providers might determine how good an intervention is and whether it is cost-effective. Total knee arthroplasty has been subjected to disease-specific, patient-specific, global health, functional capacity, and cost-to-utility outcome measures. Patient satisfaction is high (90%) after total knee arthroplasty and 93% of patients would have this operative procedure again. Large improvements in preoperative to postoperative WOMAC scores occurred (over 39 of 100 points in 82% of patients). Cost-to-quality outcomes demonstrated total knee arthroplasties are extremely cost-effective. This analysis documents total knee arthroplasty is a highly efficacious procedure that competes favorably with all medical and surgical interventions.

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    ABSTRACT: Total knee arthroplasty has provided dramatic improvements in function and pain for the majority of patients with knee arthritis, yet a significant proportion of patients remain dissatisfied with their results. We performed a prospective analysis of 215 patients undergoing TKA who underwent a comprehensive array of evaluations to discover whether any preoperative assessment could predict high pain scores and functional limitations postoperatively. Patients with severe pain with a simple knee range-of-motion test prior to TKA had a 10 times higher likelihood of moderate to severe pain at 6months. A simple test of pain intensity with active flexion and extension preoperatively was a significant predictor of postoperative pain at 6months after surgery. Strategies to address this particular patient group may improve satisfaction rates of TKA.
    The Journal of arthroplasty 02/2014; · 1.79 Impact Factor
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    ABSTRACT: Objective this study had the aim of assessing the quality of life among patients undergoing total knee arthroplasty (TKA). For this, the SF‐36 and WOMAC questionnaires respectively were used to make comparisons with preoperative values. Methods a prospective observational cohort study was conducted, with blinded analysis on the results from 107 TKAs in 99 patients, between June 2010 and October 2011. The present study included 55 knees/patients, among whom 73% were female and 27% were male. The patients’ mean age was 68 years. The SF‐36 and WOMAC questionnaires (which have been validated for the Portuguese language) were applied immediately before and six months after the surgical procedure. Results the statistical and graphical analysis indicated that the variables presented normal distribution. From the data, it was seen that all the indices underwent positive changes after the surgery. Conclusions despite the initial morbidity, TKA is a very successful form of treatment for severe osteoarthritis of the knee (i.e. more than two joint compartments affected and/or Ahlback classification greater than 3), from a functional point of view, with improvement of the patients’ quality of life, as confirmed in the present study. This study presented evidence level IV (description of case series), with analysis on the results, without a comparative study.
    Revista Brasileira de Ortopedia 03/2014; 49(2):194–201.
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    ABSTRACT: Objetivo avaliar a qualidade de vida em pacientes submetidos à artroplastia total do joelho (ATJ) com o uso dos questionários SF-36 (Medical Outcomes Study 36 – Item Short Form Health Survey) e WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) e compará-los com os valores pré-operatórios. Métodos foi feito um estudo prospectivo, observacional, coorte com análise cega dos resultados, com 107 ATJ em 99 pacientes, de junho de 2010 a outubro de 2011. Incluídos no estudo 55 joelhos/pacientes: 73% eram do sexo feminino e 27% do masculino. A média de idade foi de 68 anos. Foram aplicados os questionários SF-36 e WOMAC, validados para língua portuguesa, imediatamente antes e seis meses após o procedimento cirúrgico. Resultados a análise estatística e gráfica indica que as variáveis tiveram distribuição normal. Observando os dados, verifica-se que todos os índices sofreram alterações positivas depois da cirurgia. Conclusões a artroplastia total do joelho, apesar da morbidade inicial, é uma modalidade bem-sucedida de tratamento para osteoartrite grave (mais de dois compartimentos articulares acometidos e/ou classificação de Ahlback maior do que 3) do joelho do ponto de vista funcional, com melhoria da qualidade de vida dos pacientes, dados esses confirmados nesta pesquisa. Nível de evidência IV, descrição de série de casos, com análise de resultados, sem estudo comparativo.
    Revista Brasileira de Ortopedia (English Edition). 04/2014; 49(2):194–201.


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