The John Insall Award - Patient expectations affect satisfaction with total knee arthroplasty
The John Insall Award - Patient expectations affect satisfaction with total knee arthroplasty
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DOI：
10.1097/011.blo.0000238825.63648.1e
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发表时间：
2006-11-01
影响因子：
4.2
通讯作者：
Mathis, Kenneth B.
中科院分区：
文献类型：
--
作者：
Noble, Philip C.;Conditt, Michael A.;Mathis, Kenneth B.
对全膝关节置换术结果的满意度是高度可变的，报告对手术不满意的患者比例很小但很大。本研究的目的是确定哪些因素有助于患者对全膝关节置换术（TKR）的满意度，以及它们的相对重要性。在单侧初次TKR术后至少1年时，253名患者完成了自我管理的、经验证的“膝关节功能问卷”，该问卷检查了每名患者参与涉及膝关节的广泛活动的情况、他们的满意度以及TKR满足他们期望的程度。功能，期望和满意度之间的关联进行了检查，使用单变量和多变量logistic回归。75%的患者对膝关节置换术表示“满意”或“非常满意”，而14%的患者表示“不满意”或“非常不满意”。满意度与年龄小于60岁、没有残留症状、实现期望和没有功能障碍显著相关（p < 0.001）。对TKR的满意度主要取决于患者的期望，而不是他们的绝对功能水平。TKA结局的真实的改善必须解决残余疼痛、僵硬和肿胀的预防，以及每个患者对这些手术可能结局的术前概念。
Satisfaction with the outcome of total knee arthroplasty is highly variable, with a small but significant percentage of patients reporting dissatisfaction with the procedure. The purpose of this study was to determine which factors contribute to patient satisfaction with total knee replacement (TKR), and their relative importance. At a minimum of 1 year post unilateral primary TKR, 253 patients completed a self-administered, validated "Knee Function Questionnaire," which examined each patient's participation in a broad range of activities involving the knee, their level of satisfaction, and the extent to which TKR had fulfilled their expectations. The association between function, expectation and satisfaction was examined using univariate and multivariate logistic regression. Seventy-five percent of patients were either "satisfied" or "very satisfied" with their knee replacement, while 14% were "dissatisfied" or "very dissatisfied." Satisfaction correlated significantly (p < 0.001) with age less than 60, absence of residual symptoms, fulfillment of expectations, and absence of functional impairment. Satisfaction with TKR is primarily determined by patients' expectations, and not their absolute level of function. Real improvements in the outcome of TKA must address prevention of residual pain, stiffness and swelling, and each patient's preoperative concept of the likely outcome of these procedures.