Patient-Reported Outcomes and Satisfaction Following Total Knee Arthroplasty in Rheumatoid Arthritis: An...

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Patient Outcomes Research

Background:

• Pharmacologic therapies for rheumatoid arthritis (RA) have advanced, reducing joint damage.
• Total knee arthroplasty (TKA) remains crucial for RA patients with significant joint damage.
• Existing studies on TKA in RA primarily focus on physician-reported outcomes, neglecting patient-reported outcome measures (PROMs).

Purpose of the Study:

• To evaluate the effectiveness of TKA in patients with RA.
• To compare physician-reported outcomes with patient-reported outcome measures (PROMs) after TKA in RA patients.
• To identify factors associated with patient satisfaction following TKA in RA.

Main Methods:

• Retrospective review of 61 RA patients (61 knees) undergoing primary TKA.
• Assessment of clinical outcomes: range of motion (ROM), Japanese Orthopaedic Association (JOA) score, Knee Society Score (KSS).
• Evaluation of PROMs: Knee Injury and Osteoarthritis Outcome Score (KOOS) and a 5-grade satisfaction scale; subgroup analysis based on satisfaction.

Main Results:

• Significant improvements observed in ROM, JOA scores, and KSS (knee and function) post-TKA (P < 0.01).
• All KOOS domains improved, with 85.2% of patients reporting satisfaction.
• Satisfied patients showed significantly greater improvement in KOOS Activities of Daily Living (ADL) and Quality of Life (QOL) subscales compared to dissatisfied patients.

Conclusions:

• TKA provides substantial improvements in both physician- and patient-reported outcomes for RA patients.
• PROMs, particularly ADL and QOL, are more closely linked to postoperative satisfaction than clinician-based measures.
• Routine incorporation of PROMs is recommended for evaluating TKA outcomes in RA patients.