How Is Satisfaction after PS TKA Related to Bearing Design, Postoperative Flexion, and Comorbidities?

Q: Can it be applied directly to individual patients' treatment decisions?

This observational study does not establish a causal effect of bearing selection. Explanatory power is limited, and inclusion of postoperative flexion means it is not a purely preoperative satisfaction predictor.

There were 784 satisfied patients (91.4%) and 74 dissatisfied patients (8.6%).

Participants and Methods

858 Asian patients undergoing TKA for primary OA. This retrospective cross-sectional study assessed satisfaction on a 5-point Likert scale after at least 2 years. Demographics, comorbidities, surgical options and joint motion were analyzed with univariable and multivariable regression.

The order in which you read the painting.

The original recruitment flowchart shows participant selection and the satisfied and dissatisfied groups. It is included because a results graph was unavailable; it does not illustrate a treatment effect. This cross-sectional satisfaction analysis included 858 PS TKA patients after exclusions such as complications. Fixed-bearing and flexion-angle ORs show associations, not proof that changing the implant improves satisfaction. Consider model R² 0.112 alongside age, ethnicity and postoperative timing.

Main Findings

784 patients (91.4%) were satisfied and 74 (8.6%) dissatisfied. Satisfaction was associated with fixed-bearing (OR 2.366, P = 0.001) and greater postoperative flexion (OR 1.045, P < 0.001); cerebrovascular disease was associated with lower satisfaction (OR 0.403, P = 0.005). Model R² was 0.112.

The point of reading on surgery

The study relates PS TKA design and joint motion to patient satisfaction. Statistical associations alone do not establish universal superiority of fixed bearings or a specific flexion target.

Limitations

This observational study does not establish a causal effect of bearing selection. Its explanatory power is limited, and inclusion of postoperative flexion prevents it from being a purely preoperative satisfaction predictor. Both online and issue publication occurred in 2024.

Let's put it briefly.

What did this study confirm?

There were 784 satisfied patients (91.4%) and 74 dissatisfied patients (8.6%).

Can it be applied directly to individual patients' treatment decisions?

This observational study does not establish a causal effect of bearing selection. Explanatory power is limited, and inclusion of postoperative flexion means it is not a purely preoperative satisfaction predictor.

Keywords

Cerebrovascular disease
Fixed-bearing
Knee flexion angle
Patient satisfaction
Total knee arthroplasty
Arthroplasty, Replacement, Knee
Patient Satisfaction
Range of Motion, Articular

Abstract · Original text

Sung Eun Kim, Byung Sun Choi, Du Hyun Ro, Myung Chul Lee, Hyuk-Soo Han. Fixed-Bearing and Higher Postoperative Knee Flexion Angle as Predictors of Satisfaction in Asian Patients Undergoing Posterior-Stabilized Total Knee Arthroplasty. Clinics in orthopedic surgery. 2024;16(5):733-740. doi:10.4055/cios23166.

BACKGROUND

Patient-reported satisfaction following total knee arthroplasty (TKA) can be affected by various factors. This study aimed to assess patient satisfaction rates and identify factors related to patients, surgery, and postoperative knee motion associated with satisfaction in posterior-stabilized TKA among Asian patients.

METHODS

A retrospective cross-sectional study was conducted in patients with primary osteoarthritis who underwent TKA and had a follow-up period of over 2 years. Patient satisfaction was measured using a 5-point Likert scale, and the patients were divided into satisfied and dissatisfied groups. The factors potentially affecting satisfaction were collected, including demographics, comorbidities, surgical options, and knee motion. Univariate and multivariate regression analyses were performed.

RESULTS

Of the 858 patients included, 784 (91.4%) were satisfied and 74 (8.6%) were dissatisfied. Fixed-bearing implants and higher postoperative knee flexion angles were associated with satisfaction (odds ratio [OR], 2.366; p = 0.001 and OR, 1.045; p < 0.001, respectively), whereas cerebrovascular disease was related to dissatisfaction (OR, 0.403; p = 0.005). The regression model demonstrated moderate predictability (R 2 = 0.112).

CONCLUSIONS

Fixed-bearing implants and higher postoperative knee flexion angles were associated with patient satisfaction following TKA, whereas cerebrovascular disease was associated with dissatisfaction. The identification of these factors could help improve surgical outcomes and patient satisfaction following TKA.

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The original paper.

Fixed-Bearing and Higher Postoperative Knee Flexion Angle as Predictors of Satisfaction in Asian Patients Undergoing Posterior-Stabilized Total Knee Arthroplasty

Sung Eun Kim, Byung Sun Choi, Du Hyun Ro, Myung Chul Lee, Hyuk-Soo Han
Clinics in Orthopedic Surgery · 2024

DOI · 10.4055/cios23166 PubMed Based data

The first one examined.