Patient-reported outcome after fast-track knee arthroplasty

Purpose

The purpose of this study was to describe patient-related functional outcomes after fast-track total knee arthroplasty and unicompartmental knee arthroplasty. Furthermore, we wanted to assess physical areas where an additional need for rehabilitation could be identified, and finally, we wanted to describe the association between physical function, health-related quality-of-life (HRQOL) and patient satisfaction.

Methods

The study consisted of 211 consecutive fast-track patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one outpatient visit. The patients filled in 3 questionnaires (EQ-5D, SF36 and a disease-specific questionnaire) at 2 time points before the operation and 2 time points after the operation. The observed results were compared to normative population data for EQ-5D and SF36.

Results

Four months after the operation, the patients had reached a HRQOL level of 0.82 (SD 0.15), which was lower than the background population norm of 0.85 (n.s.), whereas it equaled the population norm at 12 months (n.s.). For SF36, physical function was 62.8 (SD 23.0) at 4 months and 66.2 (SD 24.1) at 12 months, which was lower than the background population norm of 75.0 (P < 0.01). No or mild pain and good function ability were associated with high HRQOL and patient satisfaction at follow-up.

Conclusions

There seems to be an additional need for postoperative rehabilitation after fast-track total knee arthroplasty and unicompartmental knee arthroplasty regarding early functional outcome. No or mild pain and good functional abilities at 4 months are associated with high HRQOL and patient satisfaction at 4- and 12-month follow-up.

Level of evidence

II.