Analysis Of Dissatisfaction Factors In Patients Underwent Total Knee Replacement

Objective To analyze the related factors of high patients dissatisfaction after total knee replacement,so as to provide some guidance for reducing patients dissatisfaction after total knee replacement.Methods The patients who underwent total knee replacement in the joint surgery department of the people’s Hospital of Ningxia Autonomous region people’s Hospital from January 1,2012 to December 31,2015 were followed up by telephone,outpatient and video call.According to the subjective satisfaction of patients,they were divided into satisfied and dissatisfied group.We try to analyze whether there are statistical significance differences between the two groups in complication,age,sex,cardio-cerebrovascular disease,diabetes,knee arthritis grade(K-L),educational level,body mass index(BMI),duration of medical history,unilateral and bilateral,prosthesis type,anti-osteoporosis treatment(OP),preoperative flexion deformity severity,Hospital for special surgery(HSS)and The Western Ontario and Mc Master Universities(WOMAC)knee joint score.Multivariate logistic regression analysis was used to find out the relevant risk factors that affecting the dissatisfaction of patients after total knee replacement.Results A total of 630 patients were included in this study,537 patients were followed up.The lost follow-up rate was 14.76%;712 knees of 537 patients were obtained,475(88.46%)in subjective satisfaction group and 62(11.54%)in dissatisfaction group.The age of the patients was 43-90 years old,with an average of 72.34±6.94 years old,the follow-up time was 46-93 months,the average time was 63.80 ± 12.97 months.Univariate analysis showed that there were statistical significance in complication,cardio-cerebrovascular disease,age,BMI,postoperative revisit,K-L grade,anti-OP treatment,HSS and WOMAC scores between satisfied group and dissatisfied group(P <0.05).There were no statistical significance between the two groups in terms of follow-up time,length of operation,duration of medical history,length of hospital stay,sex,educational level,diabetes mellitus,type of arthritis,severity of preoperative flexion deformity,type of prosthesis,postoperative kneeling position,unilateral and bilateral(P> 0.05);Multivariate logistic regression analysis showed that age over 70 years old,chronic pain and limitation of flexion activity and higher WOMAC score were the risk factors of postoperative dissatisfaction in patients with knee osteoarthritis(P < 0.05 and OR > 1).Conclusion 1.The occurrence of chronic pain and limitation of flexion activity are the most dangerous factor affecting patients dissatisfaction;2.Knee osteoarthritis patients who older than 70 years old were more dissatisfied.