Abstract
Background
The primary aim of this study is to identify independent preoperative predictors of
outcome and patient satisfaction for the second total knee arthroplasty (TKA).
Methods
A retrospective cohort of 454 patients undergoing an asynchronous (6 weeks or more
apart) bilateral primary TKA were identified from an arthroplasty database. Patient
demographics, comorbidities, Western Ontario and McMaster Universities Osteoarthritis
Index (WOMAC), and Short Form-12 scores were collected preoperatively and 1 year postoperatively.
Overall patient satisfaction was assessed at 1 year.
Results
The 1 year WOMAC pain score (P = .01), and improvement in WOMAC pain (P < .001) and functional (P = .002) scores were significantly lower for the second TKA. Worse preoperative WOMAC
pain, function, and stiffness scores were demonstrated to be independent predictors
of improvement in the WOMAC pain, function, and stiffness scores, respectively, for
both the first and second TKA. The overall rate of satisfaction with the first TKA
was 94.0% and 94.7% for the second TKA (P = .67). The rate of satisfaction for the second TKA was 77.8% for patients that were
dissatisfied with their first TKA, which was an independent predictor of dissatisfaction
(P = .02).
Conclusion
Improvement in pain and function is less with the second TKA, but the satisfaction
rate remains similar. There are common independent predictors for change in the WOMAC
score for the first and second TKA; however, the predictors of satisfaction were different
with no common factors. Patients that were dissatisfied with their first TKA were
more likely to be dissatisfied with their second TKA.
Level of Evidence II
Prognostic retrospective cohort study.
Keywords
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Article Info
Publication History
Published online: July 01, 2019
Accepted:
June 26,
2019
Received in revised form:
June 19,
2019
Received:
April 2,
2019
Footnotes
No author associated with this paper has disclosed any potential or pertinent conflicts which may be perceived to have impending conflict with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2019.06.056.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
