Preoperative Factors Affecting the Patient-Reported Outcome Measures following Total Knee Replacement: Socioeconomic Factors and Preoperative OKS Have a Clinically Meaningful Effect

Charis Demetriou; Jeremy Webb; Philip Sedgwick; Irrum Afzal; Richard Field; Deiary Kader

doi:10.1055/s-0040-1721089

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2022; 35(09): 940-948
DOI: 10.1055/s-0040-1721089

Original Article

Preoperative Factors Affecting the Patient-Reported Outcome Measures following Total Knee Replacement: Socioeconomic Factors and Preoperative OKS Have a Clinically Meaningful Effect

Charis Demetriou

¹Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, United Kingdom

,

Jeremy Webb

¹Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, United Kingdom

,

Philip Sedgwick

¹Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, United Kingdom

²Institute for Medical and Biomedical Education, St. George's, University of London, London, United Kingdom

,

Irrum Afzal

¹Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, United Kingdom

,

Richard Field

¹Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, United Kingdom

,

Deiary Kader

¹Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, United Kingdom

› Author Affiliations

Abstract

The Oxford Knee Score (OKS) is a patient-reported outcome questionnaire typically used to assess function and pain in patients undergoing total knee replacement (TKR). However, research is inconclusive as to which preoperative factors are important in explaining variation in outcome following TKR. The operative records of 12,709 patients who underwent primary TKR over a 9-year period were analyzed. The following variables were collected for each patient: age, sex, body mass index (BMI), Index of Multiple Deprivation decile rank, side of operation, diagnosis, the American Society of Anaesthesiologists (ASA) grade, preoperative OKS, EQ-5D index score, EuroQol visual analog scale (EQ-VAS) score, the postoperative OKS at 1 and 2 years. Generalized linear regression models were performed at 1 and 2 years to investigate the effect of the preoperative variables on the postoperative OKS. The effect of age, sex, BMI, Index of Multiple Deprivation decile rank, diagnosis, ASA grade, preoperative OKS, EuroQoL five-dimensional (EQ-5D) index score, and EQ-VAS score were all statistically significant in explaining the variation in OKS at 1 and 2 years postoperatively, with critical level of significance of 0.05 (5%). Being male aged 60 to 69 years of normal BMI, ASA grade I (fit and healthy), living in an affluent area, not reporting preoperative anxiety/depression, were associated with an enhanced mean postoperative OKS at both 1 and 2 years. When adjusted for potential confounding, age of 60–69 years, male sex, normal BMI, lower ASA grade, higher Index of Multiple Deprivation and higher pre-operative EQ-5D, EQ-VAS and OKS were identified as factors that resulted in higher post-operative OKS after primary TKR.

Keywords

Oxford Knee Score - total knee replacement - patient demographics - patient reported outcomes - arthroplasty - preoperative factors

Full Text

References

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