Factors Affecting Adherence to Follow-up Appointments after total knee arthroplasty

Regular attendance of follow-up visits after total knee arthroplasty (TKA) is an important aspect of post-TKA patient care. Hence, this study was conducted to evaluate patient adherence to follow-up visits after TKA and analyze the factors that are associated with adherence to follow-up visits following TKA.

This study was a retrospective study. The data of 411 knee osteoarthritis patients who had primary TKA were extracted from a single tertiary care hospital's electronic database. All of the pa-tients underwent the same patient care protocol. The log-rank test was used for detecting differences in follow-up survival and influencing factors. Hazard ratios (HR) were calculated using Cox proportional hazard models.

The percentage of patients attending postoperative follow-up was 99.3 percent at 6 weeks, 61.1 percent after 1 year, 38.4 percent at 2 years, 32.1 percent after 3 years, and 24.6 percent at 4 years. Hazard ratios for loss to follow-up in patients younger than 65 years of age and those 65-75 years old, compared with those over 75 years old were 2.09 and 1.49, respectively (P<0.05). Patients classified as ASA II better adhered to follow-up visits than ASA III patients. (HR 0.71, P = 0.04). Lastly, HR in patients who lived at least 100 km away from the hospital compared with those who lived less than 100 km away was 0.78 (P = 0.033).

1. Adherence to follow-up visits after TKA was lower than we had expected. 2. The importance of follow-up visits should be emphasized to all patients, and especially in those who require special attention, such as patients who are at high risk of post-operative complications.