Rheumatoid Arthritis Patients Achieve Better Satisfaction but Lower Functional Activities as Compared to Osteoarthritis Patients After Total Knee Arthroplasty

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Abstract

Background: Recently, poor patient satisfaction after total knee arthroplasty (TKA) has gained attention mainly in osteoarthritis (OA) patients; however, satisfaction after TKA remains to be understood in rheumatoid arthritis (RA) patients. This study aimed to examine satisfaction and function after RA TKA using patient-reported outcome measures and to compare the results with those of OA-TKA. Methods: This study enrolled 534 TKAs of 501 patients consisting of 75 TKAs of 70 RA patients and 459 TKAs of 431 OA patients. Data of patient-reported outcome measures such as new Knee Society Score 2011, Pain Catastrophizing Scale, and Pain DETECT Score were collected at 2 years. Multiple regression analysis was performed with Knee Society Score satisfaction score set as a dependent variable in order to clarify factors affecting patient satisfaction. Principle component analysis was performed, and satisfaction and function components were compared between RA and OA. Results: All activity scores were significantly lower in RA TKA than in OA TKA, whereas the range of motion and patient satisfaction scores were significantly better in RA TKA than in OA TKA. Scores for symptom, expectation, basic activity, and discretional activity positively affected patient satisfaction (P <.001), while Pain Catastrophizing Scale negatively did (P =.021). Importantly, diagnosis of RA itself pushed up the patient satisfaction score by 1.5 points. Principle component analysis revealed that RA TKA achieved significantly higher satisfaction component (P =.001), but lower function component (P <.0001) compared to OA TKA. Conclusion: Patient satisfaction was better but functional activity was lower in RA than in OA. As poor functional activity was evident preoperatively in RA patients, to improve functional outcome should be future challenge for RA TKA.

Original languageEnglish
JournalJournal of Arthroplasty
DOIs
Publication statusAccepted/In press - 2018 Jan 1

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Knee Replacement Arthroplasties
Osteoarthritis
Rheumatoid Arthritis
Patient Satisfaction
Knee Osteoarthritis
Catastrophization
Articular Range of Motion
Regression Analysis

Keywords

  • functional activity
  • Pain Catastrophizing Scale
  • patient satisfaction
  • patient-reported outcome measures
  • rheumatoid arthritis
  • total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

@article{91ab7210d0744e8484dc22a4d8c47307,
title = "Rheumatoid Arthritis Patients Achieve Better Satisfaction but Lower Functional Activities as Compared to Osteoarthritis Patients After Total Knee Arthroplasty",
abstract = "Background: Recently, poor patient satisfaction after total knee arthroplasty (TKA) has gained attention mainly in osteoarthritis (OA) patients; however, satisfaction after TKA remains to be understood in rheumatoid arthritis (RA) patients. This study aimed to examine satisfaction and function after RA TKA using patient-reported outcome measures and to compare the results with those of OA-TKA. Methods: This study enrolled 534 TKAs of 501 patients consisting of 75 TKAs of 70 RA patients and 459 TKAs of 431 OA patients. Data of patient-reported outcome measures such as new Knee Society Score 2011, Pain Catastrophizing Scale, and Pain DETECT Score were collected at 2 years. Multiple regression analysis was performed with Knee Society Score satisfaction score set as a dependent variable in order to clarify factors affecting patient satisfaction. Principle component analysis was performed, and satisfaction and function components were compared between RA and OA. Results: All activity scores were significantly lower in RA TKA than in OA TKA, whereas the range of motion and patient satisfaction scores were significantly better in RA TKA than in OA TKA. Scores for symptom, expectation, basic activity, and discretional activity positively affected patient satisfaction (P <.001), while Pain Catastrophizing Scale negatively did (P =.021). Importantly, diagnosis of RA itself pushed up the patient satisfaction score by 1.5 points. Principle component analysis revealed that RA TKA achieved significantly higher satisfaction component (P =.001), but lower function component (P <.0001) compared to OA TKA. Conclusion: Patient satisfaction was better but functional activity was lower in RA than in OA. As poor functional activity was evident preoperatively in RA patients, to improve functional outcome should be future challenge for RA TKA.",
keywords = "functional activity, Pain Catastrophizing Scale, patient satisfaction, patient-reported outcome measures, rheumatoid arthritis, total knee arthroplasty",
author = "Shu Kobayashi and Yasuo Niki and Kengo Harato and Takeo Nagura and Masaya Nakamura and Morio Matsumoto",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.arth.2018.11.003",
language = "English",
journal = "Journal of Arthroplasty",
issn = "0883-5403",
publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Rheumatoid Arthritis Patients Achieve Better Satisfaction but Lower Functional Activities as Compared to Osteoarthritis Patients After Total Knee Arthroplasty

AU - Kobayashi, Shu

AU - Niki, Yasuo

AU - Harato, Kengo

AU - Nagura, Takeo

AU - Nakamura, Masaya

AU - Matsumoto, Morio

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Recently, poor patient satisfaction after total knee arthroplasty (TKA) has gained attention mainly in osteoarthritis (OA) patients; however, satisfaction after TKA remains to be understood in rheumatoid arthritis (RA) patients. This study aimed to examine satisfaction and function after RA TKA using patient-reported outcome measures and to compare the results with those of OA-TKA. Methods: This study enrolled 534 TKAs of 501 patients consisting of 75 TKAs of 70 RA patients and 459 TKAs of 431 OA patients. Data of patient-reported outcome measures such as new Knee Society Score 2011, Pain Catastrophizing Scale, and Pain DETECT Score were collected at 2 years. Multiple regression analysis was performed with Knee Society Score satisfaction score set as a dependent variable in order to clarify factors affecting patient satisfaction. Principle component analysis was performed, and satisfaction and function components were compared between RA and OA. Results: All activity scores were significantly lower in RA TKA than in OA TKA, whereas the range of motion and patient satisfaction scores were significantly better in RA TKA than in OA TKA. Scores for symptom, expectation, basic activity, and discretional activity positively affected patient satisfaction (P <.001), while Pain Catastrophizing Scale negatively did (P =.021). Importantly, diagnosis of RA itself pushed up the patient satisfaction score by 1.5 points. Principle component analysis revealed that RA TKA achieved significantly higher satisfaction component (P =.001), but lower function component (P <.0001) compared to OA TKA. Conclusion: Patient satisfaction was better but functional activity was lower in RA than in OA. As poor functional activity was evident preoperatively in RA patients, to improve functional outcome should be future challenge for RA TKA.

AB - Background: Recently, poor patient satisfaction after total knee arthroplasty (TKA) has gained attention mainly in osteoarthritis (OA) patients; however, satisfaction after TKA remains to be understood in rheumatoid arthritis (RA) patients. This study aimed to examine satisfaction and function after RA TKA using patient-reported outcome measures and to compare the results with those of OA-TKA. Methods: This study enrolled 534 TKAs of 501 patients consisting of 75 TKAs of 70 RA patients and 459 TKAs of 431 OA patients. Data of patient-reported outcome measures such as new Knee Society Score 2011, Pain Catastrophizing Scale, and Pain DETECT Score were collected at 2 years. Multiple regression analysis was performed with Knee Society Score satisfaction score set as a dependent variable in order to clarify factors affecting patient satisfaction. Principle component analysis was performed, and satisfaction and function components were compared between RA and OA. Results: All activity scores were significantly lower in RA TKA than in OA TKA, whereas the range of motion and patient satisfaction scores were significantly better in RA TKA than in OA TKA. Scores for symptom, expectation, basic activity, and discretional activity positively affected patient satisfaction (P <.001), while Pain Catastrophizing Scale negatively did (P =.021). Importantly, diagnosis of RA itself pushed up the patient satisfaction score by 1.5 points. Principle component analysis revealed that RA TKA achieved significantly higher satisfaction component (P =.001), but lower function component (P <.0001) compared to OA TKA. Conclusion: Patient satisfaction was better but functional activity was lower in RA than in OA. As poor functional activity was evident preoperatively in RA patients, to improve functional outcome should be future challenge for RA TKA.

KW - functional activity

KW - Pain Catastrophizing Scale

KW - patient satisfaction

KW - patient-reported outcome measures

KW - rheumatoid arthritis

KW - total knee arthroplasty

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U2 - 10.1016/j.arth.2018.11.003

DO - 10.1016/j.arth.2018.11.003

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JO - Journal of Arthroplasty

JF - Journal of Arthroplasty

SN - 0883-5403

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