Does Early-Period Patient Dissatisfaction Turn Into Satisfaction Over Time After Total Knee Replacement?

BACKGROUND Total knee arthroplasty (TKA) is frequently used in the treatment of end-stage gonarthrosis, and the patient satisfaction rate varies. This study aimed to reveal the change in mid-term patient satisfaction results and functional scores of patients with low early postoperative satisfaction scores. MATERIAL AND METHODS We included 163 patients who underwent total knee prosthesis between September 2017 and February 2018. Among these patients, early (6 months) and mid-term (24 months) satisfaction and functional results of 34 patients with low satisfaction scores (Likert evaluations 1, 2, and 3) were evaluated. We assessed early-term functional results and satisfaction rates, mid-term analysis of patients who were not satisfied in the early period, and the relationship between functional scores and satisfaction. RESULTS The Likert score was 4 or 5 in 124 (80%) of 158 patients, and early dissatisfaction was detected in 34 patients (20%). In the early-period dissatisfied group, satisfaction scores 6 months after surgery were 1.9±1.1 (1-3) and 4.2±1 (3-5) 24 months after surgery. A statistically significant difference was observed between the dissatisfied group's early and mid-term KSS and KS values. A correlation was observed between satisfaction scores and KS and KSS scores (P<0.05). CONCLUSIONS Patients who do not have mechanical problems with total knee arthroplasty but are not satisfied with the surgery in the early period can be satisfied over time after regular follow-up, appropriate communication and information, and effective rehabilitation.

Is there an optimal timing for surgical treatment of pediatric supracondylar humerus fractures in the first 24 hours?

BACKGROUND: We aimed to determine the ideal surgical timing in the first 24 hours after admission to the hospital of pediatric supracondylar humerus fractures (SHF) that do not require emergent intervention. MATERIALS AND METHODS: Patients who underwent surgery in our institution between January 2011 and January 2019 due to pediatric Gartland type 3 SHFs were evaluated retrospectively. Open fractures, fractures associated with vascular injury and compartment syndrome, flexion type fractures were excluded. A total of 150 Gartland type 3 were included. The effect of early (<12 hours) or late (>12 hours) surgical interventions, daytime or night-time surgeries, working or non-working hour surgeries on operative parameters (operative duration and open reduction rate, reduction quality on postoperative early radiographs) were evaluated in pediatric SHFs. RESULTS: Early (<12 hours) or late (>12 hours), daytime or nighttime, working or non-working hour surgeries were found to be similar in Gartland type 3 patients regarding early postoperative reduction quality, duration of surgery, open reduction rate (p>0.05). Mean times passed from first admission to hospital until surgery were longer in working hour, late (>12 hours) and daytime surgery groups than non-working hour, early (<12 hours) and night-time surgery groups (p<0.001). CONCLUSION: Although delaying the operation to the working hours seems to prolong the time until surgery in pediatric Gartland type 3 SHF patients who do not require emergent intervention such as open fractures, neurovascular impairment and compartment syndrome, there may not be a time interval that makes a difference for the patients if surgery is performed within the first 24 hours, thus the surgery could be scheduled according to the surgeons' preference. LEVEL OF EVIDENCE: Level 3, Retrospective cohort study.