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Total knee arthroplasty in patients receiving Workers' Compensation
M A Mont1, J A Mayerson, K A Krackow
1Department of Orthopaedic Surgery, Johns Hopkins University Medical Institutions at Good Samaritan Hospital, Baltimore, MD 21239, USA. rhondamont@aol.com
The Journal of Bone and Joint Surgery. American Volume
|October 6, 1998
Summary
Workers' Compensation negatively impacts total knee arthroplasty outcomes, leading to significantly poorer results and higher revision rates compared to non-compensated patients. Surgeons should consider this factor when evaluating patient prognosis after knee replacement surgery.
Area of Science:
- Orthopedic Surgery
- Health Economics
- Rehabilitation Medicine
Background:
- Poor outcomes are common in workers with on-the-job injuries.
- Workers' Compensation (WC) is a potential factor influencing surgical outcomes.
- Total knee arthroplasty (TKA) is a common procedure for severe knee conditions.
Purpose of the Study:
- To determine the influence of Workers' Compensation on the outcome of total knee arthroplasty (TKA).
- To compare TKA outcomes between patients receiving WC and a matched control group.
Main Methods:
- A retrospective matched-cohort study comparing 42 TKA patients receiving WC with 42 TKA patients not receiving WC.
- Matching was performed on nine key parameters including age, gender, BMI, and preoperative severity.
- Outcomes were assessed using the Knee Society score, range of motion, stability, and radiographic analysis after a mean follow-up of 80 months.
Main Results:
- Patients receiving WC had significantly lower mean Knee Society scores (64 vs. 93) and a higher rate of fair/poor results or revisions (71% vs. 12%).
- No significant differences were observed in objective measures like range of motion, stability, or radiographic alignment.
- The disparity in clinical outcomes and revision rates between the WC and non-WC groups was statistically significant (p < 0.01).
Conclusions:
- Workers' Compensation is associated with poorer perceived outcomes and higher revision rates following total knee arthroplasty.
- Surgeons should be aware of the potential negative influence of WC on TKA outcomes.
- Further research may explore mechanisms behind this disparity in subjective patient-reported outcomes.