J Korean Orthop Assoc.  2007 Apr;42(2):204-215. 10.4055/jkoa.2007.42.2.204.

Patient Perspectives on Currently Controversial Issues in Total Knee Arthroplasty

• Choi JB
• Park KK
• Shin KS
• Chang CB
• Jung H
• Seong SC
• Kim TK

• KMID: 854589
• DOI: http://doi.org/10.4055/jkoa.2007.42.2.204

Abstract

PURPOSE: To examined the level of patient knowledge and their perspectives about the controversial issues in total knee arthroplasty (TKA), and to evaluate the effect of a relevant explanation about the issues on the patient preferences for their particular option. MATERIALS AND METHODS: One hundred patients who visited our clinic and decided to undergo TKA were asked to complete a questionnaire asking about their knowledge and preference for 4 controversial issues: 1) surgical timing of the bilateral TKAs, 2) use of computer assisted surgery, 3) use of minimal invasive surgery, and 4) use of ceramic femoral component. The patients completed the same questionnaire after the advantages and disadvantages of each option had been explained using an explanatory document designed based upon what was documented in the literature. RESULTS: The patients were not well-informed about the issues and received their information through a non-professional source. The patients tended to prefer new options with claimed promises before an explanation. The patients preferred the options with safety, accuracy, and proven evidence after an explanation. Male patients tended to prefer simultaneous TKAs more than female patients. Younger patients preferred ceramic femoral component claimed to have better longevity more than older patients did. CONCLUSION: This study demonstrates that patients' knowledge of the current controversial issues is very limited, and that patient preferences would be significantly changed if they were given an explanation from a physician. Balanced information should be given to patients in order for them to reach a fair decision.

Keyword

Total knee arthroplasty; Controversial issues; Patient perspective

MeSH Terms

Female
Male
Humans

Reference

1. Bae DK, Cho CH. Survival and functional analysis of implants in total knee replacement. J Korean Orthop Assoc. 2000. 35:211–218.

2. Bae DK, Yoon KH, Song SJ, Kim SG, Im YJ, Kim MH. Comparative analysis of radiologic measurement according to TKR using computer assisted surgery and conventional TKR. J Korean Orthop Assoc. 2005. 40:398–402.

3. Borden LS, Perry JE, Davis BL, Owings TM, Grabiner MD. A biomechanical evaluation of one-stage vs two-stage bilateral knee arthroplasty patients. Gait Posture. 1999. 9:24–30.

4. Cho WS, Jeong YG, Park JH, Kim KY, Youn DJ, Shin JM. Analysis of 1,000 cases of total knee arthroplasty: preliminary report. J Korean Orthop Assoc. 2001. 36:409–414.

5. Dalury DF, Dennis DA. Mini-incision total knee arthroplasty can increase risk of component malalignment. Clin Orthop Relat Res. 2005. 440:77–81.

6. Knutson K, Lindstrand A, Lidgren L. Survival of knee arthroplasties. A nation-wide multicentre investigation of 8,000 cases. J Bone Joint Surg Br. 1986. 68:795–803.

7. Insall J, Scott WN, Ranawat CS. The total condylar knee prosthesis. A report of two hundred and twenty cases. J Bone Joint Surg Am. 1979. 61:173–180.

8. March LM, Cross M, Tribe KL, et al. Two knees or not two knees? Patient cost and outcomes following bilateral and unilateral total knee joint replacement surgery for OA. Osteoarthritis Cartilage. 2004. 12:400–408.

9. Moreland JR. Mechanisms of failure in total knee arthroplasty. Clin Orthop Relat Res. 1988. 226:49–64.

10. Rand JA, Ilstrup DM. Survivorship analysis of total knee arthroplasty. Cumulative rates of survival of 9,200 total knee arthroplasties. J Bone Joint Surg Am. 1991. 73:397–409.

11. Sohn SW, Bae KC, Park JU, Eum DS, Lee HK. Comparative analysis of image-free navigation system-assisted TKA and conventional TKA. J Korean Knee Soc. 2005. 17:8–14.

12. Sparmann M, Wolke B. Value of navigation and robot-guided surgery in total knee arthroplasty. Orthopade. 2003. 32:498–505.

13. Spector BM, Ries MD, Bourne RB, Sauer WS, Long M, Hunter G. Wear performance of ultra-high molecular weight polyethylene on oxidized zirconium total knee femoral components. J Bone Joint Surg Am. 2001. 83:Suppl 2 Pt 2. 80–86.

14. Tenholder M, Clarke HD, Scuderi GR. Minimal-incision total knee arthroplasty: the early clinical experience. Clin Orthop Relat Res. 2005. 440:67–76.

15. Tsukamoto R, Chen S, Asano T, et al. Improved wear performance with cross-linked UHMWPE and zirconiaimplants in knee simulation. Aota Orthop. 2006. 77:505–511.

16. Walker PS, Blunn GW, Lilley PA. Wear testing of materials and surfaces for total knee replacement. J Biomed Master Res. 1996. 33:159–175.

17. Walmsley P, Murray A, Brenkel IJ. The practice of bilateral, simultaneous total knee replacement in Scotland over the last decade. Data from the Scottish Arthroplasty Project. Knee. 2006. 13:102–105.

18. Yau WP, Leung A, Chiu KY, Tang WM, Ng TP. Intraobserver errors in obtaining visually selected anatomic landmarks during registration process in nonimage-based navigation-assisted total knee arthroplasty: a cadaveric experiment. J Arthroplasty. 2005. 20:591–601.