Impact of Age on Patient-Reported Outcome Measures in Total Knee Arthroplasty.

Patient expectations and demographics are vital factors in determining patient satisfaction and outcomes from total knee arthroplasty (TKA). This study was a retrospective chart review that analyzed data from TKA patients to determine the impact of age on patient-reported outcomes measures following TKA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford knee scores were collected as primary outcome measures from 356 consecutive patients who underwent TKA. Oxford knee scores were further divided into pain and function subscores. Patients were age categorized as <50, 50 to 59, 60 to 69, 70 to 79, and >79. Preoperative scores were compared among age categories including age category, gender, body mass index (BMI), and length of stay (LOS) in the model as fixed effects. Scores collected postoperatively (∼10, 30, 90, and 180 days postoperation) were analyzed as repeated measures including age category, day and their interaction, gender, BMI, LOS, and preoperative score in the model. Preoperative OXFORD scores significantly differed among age categories (p < 0.05) and were numerically higher for the older (≥60 years old) compared with younger patients (<60 years old). After adjusting for preoperative scores, postoperative WOMAC and overall, pain, and function OXFORD scores significantly differed among the age groups (p < 0.05), with patients younger than 60 years reporting the worst scores in the postoperative time period. Older patients reported better preoperative overall, pain, and function scores and greater post-TKA outcomes than younger patients. A better understanding of factors that influence patient-reported outcomes can help providers to better manage patient expectations.

Does Marital Status Impact Outcomes After Total Knee Arthroplasty?

BACKGROUND: There is a paucity of research on the relationship between marital status and patient outcomes following total knee arthroplasty (TKA). METHODS: This was a retrospective chart review of patients who underwent TKA by a single surgeon at a university-based orthopedic practice. Data abstracted included age, gender, marital status, body mass index, length of hospital stay, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Knee Score (OKS). The WOMAC and OKS were administered at the preoperative visit and at approximately 10, 30, 90, and 180 days after TKA. Multivariate analyses with patient-reported outcomes as repeated measures, marital status, day of assessment; and the interaction of marital status and day of assessment as fixed effects; and age, gender, body mass index, and length of hospital stay as covariates were conducted as well as analyses in which preoperative patient-reported outcomes were treated as fixed effects. RESULTS: Of 422 patients who underwent TKA during the study period, complete data were available for 249, of whom 124 were married and 125 unmarried. Married patients had significantly higher WOMAC scores than unmarried patients at all postoperative assessments, even after controlling for preoperative scores. Although married patients also had significantly higher postoperative OKS scores than their unmarried peers, differences between groups were attenuated after adjusting for preoperative OKS scores. CONCLUSION: This study found that married patients have better overall outcomes after TKA but yielded conflicting results as to whether the positive effects of marriage are specific to the postoperative period.