Health Related Quality of Life in Osteoarthritis Patients with Total Knee Replacement: A Longitudinal Cohort Study

Abstract

Introduction: End-stage knee results in pain, loss of physical function and a decrease in Quality Of Life (QOL). Total Knee Replacement (TKR) is one of the most successful surgical interventions, providing substantial relief from pain. Because patient’s perceptions of treatment outcomes may vary from clinician’s judgment; measuring patient’s perspectives using Health Related Quality of Life (HRQOL) instruments has become an important approach for outcome evaluation. Aim: To assess the HRQOL outcome after TKR in patients with Osteoarthritis (OA) Knee. Materials and Methods: A longitudinal cohort study was conducted in Orthopaedic Department of tertiary care teaching hospital from July 2018 to June 2020. Of 63 patients eligible for the study, 56 completed the follow-up data. Knee injury and Osteoarthritis Outcome Score (KOOS) was measured preoperatively. Patients were followed-up at three months and six months, and postoperative KOOS were measured to evaluate HRQOL after TKR. Student t-test was used to analyse differences between KOOS mean aggregate and subscale scores. Results: There were 34 (60.71%) females and 22 (39.29%) males in the study. Mean age of the study population was 58.93±9.57 years. Left knee was involved in 33 (58.93%) cases and right in 23 (41.07%) cases. There was significant difference in preoperative KOOS (prKOOS) and postoperative KOOS (psKOOS) in the patients (p-value<0.001). It was observed that 29 (51.79%) patients were having excellent HRQOL outcome (psKOOS ≥90), 9 (16.07%) each good (psKOOS 80-89), 8 (14.29%) fair (psKOOS 70-79) HRQOL outcome and 10 (17.86%) poor HRQOL outcome (psKOOS <70) at six 6 months follow-up. Conclusion: At six months follow-up there was significant improvement in KOOS as well as subscales of symptom, pain, Activities of Daily Living (ADL), sport/recreation and QOL score. Thus, it can be said that TKR leads to significant improvement in HRQOL.

Keywords

• body mass index
• knee extensor mechanism
• knee injury and osteoarthritis outcome score