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The Journal of Hip Surgery 2020; 04(02): 084-089
DOI: 10.1055/s-0040-1712523
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Comparative Analysis of Patient Satisfaction following Total Knee Arthroplasty and Total Hip Arthroplasty Using the Forgotten Joint Score

Vivek Singh 
1   Department of Orthopedic Surgery, NYU Langone Health, New York, New York
,
Stephen Zak
1   Department of Orthopedic Surgery, NYU Langone Health, New York, New York
,
Ran Schwarzkopf
1   Department of Orthopedic Surgery, NYU Langone Health, New York, New York
,
Roy Davidovitch
1   Department of Orthopedic Surgery, NYU Langone Health, New York, New York
› Author Affiliations
Further Information

Publication History

02 March 2020

14 April 2020

Publication Date:
30 June 2020 (online)

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Abstract

Measuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.

Keywords

patient-reported outcome - total hip arthroplasty - total knee arthroplasty - Forgotten Joint Score - FJS-12
 

  • References

  • 1 Anderson JG, Wixson RL, Tsai D, Stulberg SD, Chang RW. Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty 1996; 11 (07) 831-840
    CrossrefPubMedGoogle Scholar
  • 2 Bourne RB, McCalden RW, MacDonald SJ, Mokete L, Guerin J. Influence of patient factors on TKA outcomes at 5 to 11 years follow up. Clin Orthop Relat Res 2007; 464 (464) 27-31
    CrossrefPubMedGoogle Scholar
  • 3 Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 2004; 86 (05) 963-974
    CrossrefPubMedGoogle Scholar
  • 4 Jones CA, Voaklander DC, Johnston DW, Suarez-Almazor ME. The effect of age on pain, function, and quality of life after total hip and knee arthroplasty. Arch Intern Med 2001; 161 (03) 454-460
    CrossrefPubMedGoogle Scholar
  • 5 Lau RL, Gandhi R, Mahomed S, Mahomed N. Patient satisfaction after total knee and hip arthroplasty. Clin Geriatr Med 2012; 28 (03) 349-365
    CrossrefPubMedGoogle Scholar
  • 6 Janse AJ, Gemke RJBJ, Uiterwaal CSPM, van der Tweel I, Kimpen JLL, Sinnema G. Quality of life: patients and doctors don't always agree: a meta-analysis. J Clin Epidemiol 2004; 57 (07) 653-661
    CrossrefPubMedGoogle Scholar
  • 7 Bullens PHJ, van Loon CJM, de Waal Malefijt MC, Laan RFJM, Veth RPH. Patient satisfaction after total knee arthroplasty: a comparison between subjective and objective outcome assessments. J Arthroplasty 2001; 16 (06) 740-747
    CrossrefPubMedGoogle Scholar
  • 8 Suda AJ, Seeger JB, Bitsch RG, Krueger M, Clarius M. Are patients' expectations of hip and knee arthroplasty fulfilled? A prospective study of 130 patients. Orthopedics 2010; 33 (02) 76-80
    CrossrefPubMedGoogle Scholar
  • 9 Shakoor N, Block JA, Shott S, Case JP. Nonrandom evolution of end-stage osteoarthritis of the lower limbs. Arthritis Rheum 2002; 46 (12) 3185-3189
    CrossrefPubMedGoogle Scholar
  • 10 Behrend H, Giesinger K, Giesinger JM, Kuster MS. The “forgotten joint” as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty 2012; 27 (03) 430-436.e1
    PubMedGoogle Scholar
  • 11 Giesinger JM, Kuster MS, Behrend H, Giesinger K. Association of psychological status and patient-reported physical outcome measures in joint arthroplasty: a lack of divergent validity. Health Qual Life Outcomes 2013; 11: 64
    CrossrefPubMedGoogle Scholar
  • 12 Thienpont E, Opsomer G, Koninckx A, Houssiau F. Joint awareness in different types of knee arthroplasty evaluated with the Forgotten Joint score. J Arthroplasty 2014; 29 (01) 48-51
    CrossrefPubMedGoogle Scholar
  • 13 Giesinger JM, Kuster MS, Holzner B, Giesinger K. Development of a computer-adaptive version of the forgotten joint score. J Arthroplasty 2013; 28 (03) 418-422
    CrossrefPubMedGoogle Scholar
  • 14 Thompson SM, Salmon LJ, Webb JM, Pinczewski LA, Roe JP. Construct validity and test re-test reliability of the Forgotten Joint score. J Arthroplasty 2015; 30 (11) 1902-1905
    CrossrefPubMedGoogle Scholar
  • 15 Chesworth BM, Mahomed NN, Bourne RB, Davis AM. ; OJRR Study Group. Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery. J Clin Epidemiol 2008; 61 (09) 907-918
    CrossrefPubMedGoogle Scholar
  • 16 Bachmeier CJM, March LM, Cross MJ. , et al; Arthritis Cost and Outcome Project Group. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage 2001; 9 (02) 137-146
    CrossrefPubMedGoogle Scholar
  • 17 Fitzgerald JD, Orav EJ, Lee TH. , et al. Patient quality of life during the 12 months following joint replacement surgery. Arthritis Rheum 2004; 51 (01) 100-109
    CrossrefPubMedGoogle Scholar
  • 18 Hozack WJ, Rothman RH, Albert TJ, Balderston RA, Eng K. Relationship of total hip arthroplasty outcomes to other orthopaedic procedures. Clin Orthop Relat Res 1997; (344) 88-93
    PubMedGoogle Scholar
  • 19 Kirwan JR, Currey HLF, Freeman MAR, Snow S, Young PJ. Overall long-term impact of total hip and knee joint replacement surgery on patients with osteoarthritis and rheumatoid arthritis. Br J Rheumatol 1994; 33 (04) 357-360
    CrossrefPubMedGoogle Scholar
  • 20 Wylde V, Blom AW, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC. Patient-reported outcomes after total hip and knee arthroplasty: comparison of midterm results. J Arthroplasty 2009; 24 (02) 210-216
    CrossrefPubMedGoogle Scholar
  • 21 Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res 2010; 468 (01) 57-63
    CrossrefPubMedGoogle Scholar
  • 22 Fortin PR, Clarke AE, Joseph L. , et al. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum 1999; 42 (08) 1722-1728
    CrossrefPubMedGoogle Scholar
  • 23 Bourne RB, Chesworth B, Davis A, Mahomed N, Charron K. Comparing patient outcomes after THA and TKA: is there a difference?. Clin Orthop Relat Res 2010; 468 (02) 542-546
    CrossrefPubMedGoogle Scholar
  • 24 Bradbury N, Borton D, Spoo G, Cross MJ. Participation in sports after total knee replacement. Am J Sports Med 1998; 26 (04) 530-535
    CrossrefPubMedGoogle Scholar
  • 25 Hilding MB, Bäckbro B, Ryd L. Quality of life after knee arthroplasty. A randomized study of 3 designs in 42 patients, compared after 4 years. Acta Orthop Scand 1997; 68 (02) 156-160
    PubMedGoogle Scholar
  • 26 Mallon WJ, Callaghan JJ. Total hip arthroplasty in active golfers. J Arthroplasty 1992; (Suppl. 07) 339-346
    PubMedGoogle Scholar
  • 27 Benroth R, Gawande S. Patient-reported health status in total joint replacement. J Arthroplasty 1999; 14 (05) 576-580
    CrossrefPubMedGoogle Scholar
  • 28 Issa K, Pivec R, Kapadia BH. , et al. Does obesity affect the outcomes of primary total knee arthroplasty?. J Knee Surg 2013; 26 (02) 89-94
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 McElroy MJ, Pivec R, Issa K, Harwin SF, Mont MA. The effects of obesity and morbid obesity on outcomes in TKA. J Knee Surg 2013; 26 (02) 83-88
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Behrend H, Zdravkovic V, Giesinger J, Giesinger K. Factors predicting the forgotten joint score after total knee arthroplasty. J Arthroplasty 2016; 31 (09) 1927-1932
    CrossrefPubMedGoogle Scholar
  • 31 Thienpont E, Vanden Berghe A, Schwab PE, Forthomme JP, Cornu O. Joint awareness in osteoarthritis of the hip and knee evaluated with the ‘Forgotten Joint’ score before and after joint replacement. Knee Surg Sports Traumatol Arthrosc 2016; 24 (10) 3346-3351
    CrossrefPubMedGoogle Scholar