RESUMEN
Objective This study aimed to assess the rate of patient satisfaction after primary total joint arthroplasty (TJA) using a validated satisfaction measure. Materials and methods A cross-sectional study was conducted, including all patients who underwent primary TJA between December 2021 and February 2023. The age of the study population was found to range from 23 to 86 years. Patient satisfaction was assessed using a validated tool comprising four questions and a quality of life (QoL) question. Results A total of 197 patients were included, with a mean age of 60.9 ± 12.7 years. Total knee replacement (TKR) was performed in 124 patients (62.9%), and total hip replacement (THR) in 73 patients (37.1%). The mean patient satisfaction score was 86.6 ± 14.4 out of a maximum of 100. A significant negative correlation was observed between the Charlson Comorbidity Index (CCI) and the overall satisfaction score (p-value = 0.029). The majority of the patients (52.3%, n = 103) answered that their QoL had greatly improved, and a similar level of improvement was noted in elderly vs. adult patients (p-value = 0.17). A significantly higher proportion of male patients reported improvement more than they ever expected compared to female patients, the majority of whom reported their QoL was greatly improved (p-value = 0.025). Conclusion Total joint arthroplasty has been shown to achieve good patient satisfaction and an improvement in QoL. However, an increased comorbidity index and female gender were identified as factors for reduced satisfaction. Hence, it is recommended to consider these factors and counsel patients accordingly based on local patient data.
RESUMEN
Objective The objective was to evaluate the modified frailty index as a predictor of early (within 30 days) postoperative complications in total joint arthroplasty patients, in a low middle-income country. Material and methods A cross-sectional study was carried out which included patients with ages ranging from 23 to 86 years, who underwent elective primary Total Hip or Knee Arthroplasties (TKA or THA) between December 2021 and February 2023. Modified frailty index (mFI-5) was calculated and 30-day morbidity and mortality were recorded. Post-operative complications were categorized as either surgical or medical and recorded. Results A total of 175 patients were included, amongst whom the majority were females (68.6%, n=120) and the mean age was 60.5 ± 13.2 years. 85 patients (48.6%) had a mFI-5 score of one while 48 patients (27.4%) had a score of two. Superficial surgical site infection was the most common complication overall in 6 patients (3.4%); however, no case of prosthetic joint infection was noted. Deep vein thrombosis (DVT) was the most common medical complication (1.7%, n=3). 5 patients (2.9%) required re-admission and two mortalities were recorded within the 30-day interval. A significant association was noted between post-operative surgical complications and mFI-5 score (p-value = < 0.001), with the risk of complications increasing with a higher mFI-5 score. Smoking was noted to be a risk factor for post-operative medical complications as well as 30-day mortality. Conclusion The current study shows that the mFI-5 index can effectively be used as a predictor of postoperative complications in the South Asian region such as Pakistan. This should be calculated routinely and can be used as a tool for pre-operative assessment and counseling.
