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The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty

Lookup NU author(s): Lucy Walker, Michelle Bardgett, Craig Gerrand, Professor David Deehan

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Abstract

© 2018 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) Purpose: The primary aim of this study was to define a classification in the WOMAC score after total knee arthroplasty (TKA) according to patient satisfaction. The secondary aims were to describe patient demographics for each level of satisfaction. Methods: A retrospective cohort consisting of 2589 patients undergoing a primary TKA were identified from an established arthroplasty database. Patient demographics, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and short form (SF) 12 scores were collected pre-operatively and 1 year post-operatively. In addition, patient satisfaction was assessed at 1 year with four responses: very satisfied, satisfied, dissatisfied or very dissatisfied. Receiver operating characteristic (ROC) curves were used to identify values in the components and total WOMAC scores that were predictive of each level of satisfaction, which were used to define the categories of excellent, good, fair and poor. Results: At 1 year, there were 1740 (67.5%) very satisfied, 572 (22.2%) satisfied, 190 (7.4%) dissatisfied and 76 (2.9%) very dissatisfied patients. ROC curve analysis identified excellent, good, fair and poor categories for the pain (> 78, 59–78, 44–58, < 44), function (> 72, 54–72, 41–53, < 41), stiffness (> 69, 56–69, 43–55, < 43) and total (> 75, 56–75, 43–55, < 43) WOMAC scores, respectively. Patients with lung disease, diabetes, gastric ulcer, kidney disease, liver disease, depression, back pain, with worse pre-operative functional scores (WOMAC and SF-12) and those with less of an improvement in the scores, had a significantly lower level of satisfaction. Conclusion: This study has defined a post-operative classification of excellent, good, fair and poor for the components and total WOMAC scores after TKA. The predictors of level of satisfaction should be recognised in clinical practice and patients at risk of a lower level of satisfaction should be made aware in the pre-operative consent process. Level of evidence: III.


Publication metadata

Author(s): Walker LC, Clement ND, Bardgett M, Weir D, Holland J, Gerrand C, Deehan DJ

Publication type: Article

Publication status: Published

Journal: Knee Surgery, Sports Traumatology, Arthroscopy

Year: 2018

Volume: 26

Issue: 11

Pages: 3333-3341

Online publication date: 26/02/2018

Acceptance date: 12/02/2018

ISSN (print): 0942-2056

ISSN (electronic): 1433-7347

Publisher: Springer Verlag

URL: https://doi.org/10.1007/s00167-018-4879-5

DOI: 10.1007/s00167-018-4879-5


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