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Early post-operative oxford knee score and knee society score predict patient satisfaction 2 years after total knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

There is poor correlation between functional outcomes and patient satisfaction following total knee arthroplasty (TKA). We asked if early post-operative scores at 6 months or the pre- to post-operative change in scores are predictive of patient satisfaction 2 years after TKA.

Methods

We conducted a retrospective review of prospectively collected registry data of 4359 TKAs performed at a single institution. At 6 months and 2 years, the Knee Society Score (KSS), Oxford Knee Score (OKS), and Short-Form 36 scores were assessed. A satisfaction questionnaire was also completed. Logistic regression was used to generate receiver-operating characteristic (ROC) curves to assess the ability of each scoring system in predicting satisfaction at 2 years.

Results

At 2 years, 91.1% of patients were satisfied. For the absolute post-operative OKS at 6 months, an AUC of 0.762 (95% CI 0.736–0.788) and a threshold of ≤ 21.5 points (or ≥ 38.5 points on the new scale) were obtained. For the KSS knee score, an AUC of 0.704 (95% CI 0.674–0.734) and a threshold of ≥ 80.5 points were identified. The OKS performed significantly better than the KSS knee score (p = 0.03) and the other post-operative scores (p < 0.001). When analysing the change in scores pre-operatively to 6 months, the AUC was < 0.7 for all scales.

Conclusions

Early post-operative scores, specifically the OKS and KSS knee score, can predict patient satisfaction at 2 years after TKA with good accuracy. The threshold values offer surgeons an additional tool to identify patients at risk of dissatisfaction at 2 years, enabling them to intervene earlier to ensure good patient satisfaction.

Level of evidence

III, retrospective cohort study

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore

    Graham S. Goh, Hamid Rahmatullah Bin Abd Razak, Darren Keng-Jin Tay, Ngai-Nung Lo & Seng-Jin Yeo

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  1. Graham S. Goh
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  2. Hamid Rahmatullah Bin Abd Razak
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  3. Darren Keng-Jin Tay
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  4. Ngai-Nung Lo
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Correspondence to Graham S. Goh.

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Centralised institutional review board (IRB) approval (CIRB 2018/2386) was obtained for this study.

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Informed consent was obtained from all individual participants include in the study.

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This work was performed at Singapore General Hospital, Singapore.

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Goh, G.S., Bin Abd Razak, H.R., Tay, D.KJ. et al. Early post-operative oxford knee score and knee society score predict patient satisfaction 2 years after total knee arthroplasty. Arch Orthop Trauma Surg 141, 129–137 (2021). https://doi.org/10.1007/s00402-020-03612-2

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