Maximizing patient satisfaction and functional results after total knee arthroplasty.
*Arthroplasty; *Outcome Assessment (Health Care); *Patient Satisfaction; Humans; Knee Prosthesis; Knee/rehabilitation; Minimally Invasive Surgical Procedures; Pain; Patient Education as Topic; Physical Therapy Modalities; Postoperative Care; Postoperative/prevention & control; Preoperative Care; Prosthesis Design; Replacement
The purpose of this article is to review the issues regarding preoperative patient expectations for total knee arthroplasty and whether or not these are fulfilled after surgery. The demographics of the typical total knee arthroplasty patient are changing, and the expectations regarding the outcome of the surgery have been changing as well. Patients are younger, heavier, more active, and often come to the surgeon's office with information provided via the Internet that may be inaccurate and/or misleading. Many expect and assume that the operation will return the knee to "normal." Traditional outcomes measures used by orthopedic surgeons to determine the quality of the results achieved are inadequate and do not take into account the higher expectations of current patients. Various strategies have been developed to improve satisfaction after the surgery. These include preoperative patient education, less invasive surgical approaches, advances in prosthetic design, multimodal pain management, and aggressive postoperative rehabilitation. Using these strategies will make preoperative expectations more realistic and improve postoperative satisfaction.
Greene Kenneth; Harwin Steven F
The journal of knee surgery
2011
2011-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1055/s-0031-1275389" target="_blank" rel="noreferrer noopener">10.1055/s-0031-1275389</a>
Outcomes of modular proximal femoral replacement in the treatment of complex proximal femoral fractures: a case series.
*Outcome Assessment (Health Care); *Prostheses and Implants; 80 and over; Aged; Arthroplasty; Female; Femoral Fractures/diagnostic imaging/*surgery; Follow-Up Studies; Fracture Fixation; Humans; Internal/adverse effects; Male; Middle Aged; Radiography; Salvage Therapy; Treatment Failure
BACKGROUND: The treatment of complex femur fractures poses a significant challenge. Even with current advancements and the various implements available for the fixation of femoral fractures, results are often disappointing. This study sought to identify problems associated with and examine results of modular proximal femoral replacement. Outcomes were evaluated in two groups of patients: those receiving primary modular proximal femoral replacement for fractures and those treated with salvage arthroplasty for failed internal fixation. METHODS: Twelve patients who had received modular proximal femoral replacement as primary treatment for proximal femoral fractures were evaluated along with nine patients treated with salvage proximal femoral replacement for failed internal fixation. After the surgical procedure, patients were evaluated at regular follow-up intervals and contacted by phone at the conclusion of this study. Patient functional results were evaluated using the Merle D'Aubigne hip rating scale, which measures pain, motion and ambulatory status. Routine radiographs were also obtained at each patient visit. RESULTS: On average, patients who received modular proximal femoral replacement as the primary surgery for their femoral fractures enjoyed a high-level functional result and had few complications. Subjects who received salvage femoral replacement had a less optimal outcome and experienced more complications. Nonetheless, final post-operative MDA score was significantly increased from pre-operative levels. CONCLUSION: Modular proximal femoral replacement is a viable option in the primary fracture or revision setting, and has been shown to have a reasonable outcome, especially when the nature of initial injury is taken into account.
Schoenfeld Andrew J; Leeson Mark C; Vrabec Gregory A; Scaglione Joseph; Stonestreet Matthew J
International journal of surgery (London, England)
2008
2008-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ijsu.2008.01.009" target="_blank" rel="noreferrer noopener">10.1016/j.ijsu.2008.01.009</a>