Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Research

Education level has an effect on the recovery of total knee arthroplasty: a retrospective study

Authors: Yuan-yuan Zhou, Bo-kai Zhang, Tian-fei Ran, Song Ke, Tian-ying Ma, Yin-yin Qin, Yuan Zhang, Yuan Xu, Min Wang

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Login to get access

Abstract

Objective

This study aimed to observe the relationship between education level and outcomes after total knee arthroplasty (TKA).

Methods

One thousand two hundred sixty four patients after TKA in our hospital from April 2016 to April 2020 were reviewed. These patients were divided into 4 groups (A who were illiterate, B who had elementary school degree, C who had junior high school degree, D who had senior high school degree or higher) by the educational level, which was blinded to the observers. The postoperative outcomes of KSS score, pain, joint extension and flexion function were observed 1 year after discharged from hospital.

Results

Among 1253 patients met the inclusion criteria, the average age was 68.63 years, the average body mass was 57.73 kg. There are no distinctions among 4 groups one day after the surgery. However, the outcomes of the follow up were that, the KSS score was: 77.84 ± 10.635; 80.70 ± 8.956; 87.92 ± 8.123;91.27 ± 8.262, with significant differences (P < 0.05). The mean VAS scores were: 1.97 ± 1.60; 2.07 ± 1.66; 1.197 ± 1.5265, 1.044 ± 1.4662. Patients in Group C and D had significantly less pain than that in Group A and B (P < 0.05). The knee flexion range of motion (ROM) was: 91.21 ± 11.69°; 91.77 ± 11.95°; 102.12 ± 11.38°; 109.96 ± 10.64°, Group D performed best, with significant differences (P < 0.05). The knee extension ROM were: – 2.41 ± 4.49°; – 0.91 ± 2.82°; – 0.83 ± 2.87°; – 0.35 ± 1.60°, with significant difference between Group D and the others (P < 0.05).

Conclusion

Education level affects the outcomes such as VAS score, KSS score, the extension and flexion ROM of the knee after TKA. The patients with higher education level have better outcomes.
Literature
1.
go back to reference Buhagiar MA, Naylor JM, Harris IA. Assessment of outcomes of inpatient or clinic-based vs home-based rehabilitation after total knee arthroplasty: a systematic review and meta-analysis. JAMA Netw Open. 2019;2(4):e192810–e192810.CrossRef Buhagiar MA, Naylor JM, Harris IA. Assessment of outcomes of inpatient or clinic-based vs home-based rehabilitation after total knee arthroplasty: a systematic review and meta-analysis. JAMA Netw Open. 2019;2(4):e192810–e192810.CrossRef
2.
go back to reference Zongke Z, Xisheng W, Tiebing Q, al. e. Expert consensus in enhanced recovery after total hip and knee arthroplasty in China: perioperative management. Chin J Bone Joint Surg. 2016;9(1):1–9. (in Chinese) Zongke Z, Xisheng W, Tiebing Q, al. e. Expert consensus in enhanced recovery after total hip and knee arthroplasty in China: perioperative management. Chin J Bone Joint Surg. 2016;9(1):1–9.  (in Chinese)
3.
go back to reference Jiang S, Xiang J, Gao X, Guo K, Liu B. The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: a systematic review and meta-analysis. J Telemed Telecare. 2018;24(4):257–62.CrossRef Jiang S, Xiang J, Gao X, Guo K, Liu B. The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: a systematic review and meta-analysis. J Telemed Telecare. 2018;24(4):257–62.CrossRef
4.
go back to reference Tolk JJ, Janssen RPA, Haanstra TM, Bierma-Zeinstra SMA, Reijman M. The EKSPECT study: the influence of expectation modification in Knee arthroplasty on satisfaction of patients: study protocol for a randomized controlled trial. Trials. 2018;19(1):437–437.CrossRef Tolk JJ, Janssen RPA, Haanstra TM, Bierma-Zeinstra SMA, Reijman M. The EKSPECT study: the influence of expectation modification in Knee arthroplasty on satisfaction of patients: study protocol for a randomized controlled trial. Trials. 2018;19(1):437–437.CrossRef
5.
go back to reference Chen M, Li P, Lin F. Influence of structured telephone follow-up on patient compliance with rehabilitation after total knee arthroplasty. Patient Prefer Adherence. 2016;10:257–64. Chen M, Li P, Lin F. Influence of structured telephone follow-up on patient compliance with rehabilitation after total knee arthroplasty. Patient Prefer Adherence. 2016;10:257–64.
6.
go back to reference Anderson AM, Comer C, Smith TO, et al. Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified delphi study. BMC musculoskelet disord. 2021;22(1):352.CrossRef Anderson AM, Comer C, Smith TO, et al. Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified delphi study. BMC musculoskelet disord. 2021;22(1):352.CrossRef
7.
go back to reference Albayrak I, Apiliogullari S, Erkocak OF, et al. Total knee arthroplasty due to knee osteoarthritis: risk factors for persistent postsurgical pain. J Natl Med Association. 2016;108(4):236–43.CrossRef Albayrak I, Apiliogullari S, Erkocak OF, et al. Total knee arthroplasty due to knee osteoarthritis: risk factors for persistent postsurgical pain. J Natl Med Association. 2016;108(4):236–43.CrossRef
8.
go back to reference Birch S, Stilling M, Mechlenburg I, Hansen TB. Effectiveness of a physiotherapist delivered cognitive-behavioral patient education for patients who undergoes operation for total knee arthroplasty: a protocol of a randomized controlled trial. BMC Musculoskelet Disord. 2017;18(1):116.CrossRef Birch S, Stilling M, Mechlenburg I, Hansen TB. Effectiveness of a physiotherapist delivered cognitive-behavioral patient education for patients who undergoes operation for total knee arthroplasty: a protocol of a randomized controlled trial. BMC Musculoskelet Disord. 2017;18(1):116.CrossRef
9.
go back to reference Katz JN, Arant KR, Loeser RF. Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA. 2021;325(6):568–78.CrossRef Katz JN, Arant KR, Loeser RF. Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA. 2021;325(6):568–78.CrossRef
10.
go back to reference Lan Y, Ling L, Yong L. Influencing factors and nursing intervention on self-efficacy of rehabilitative training for patients undergoing hip and knee replacement surgery-fen. Nurs Pract Res. 2020;17(15):15–7. Lan Y, Ling L, Yong L. Influencing factors and nursing intervention on self-efficacy of rehabilitative training for patients undergoing hip and knee replacement surgery-fen. Nurs Pract Res. 2020;17(15):15–7.
11.
go back to reference Bakaa N, Chen LH, Carlesso L, et al. Understanding barriers and facilitators of exercise adherence after total-knee arthroplasty. Disabil Rehabil. 2021;44:1–8. Bakaa N, Chen LH, Carlesso L, et al. Understanding barriers and facilitators of exercise adherence after total-knee arthroplasty. Disabil Rehabil. 2021;44:1–8.
12.
go back to reference Ai’erxiding·A’bulaiti, Chang X, Qiang M, Zhi-min S. Factors influencing joint function recovery of knee osteoarthritis after total knee arthroplasty. Chin J Bone Joint. 2020;9(2):104-7. (in Chinese) Ai’erxiding·A’bulaiti, Chang X, Qiang M, Zhi-min S. Factors influencing joint function recovery of knee osteoarthritis after total knee arthroplasty. Chin J Bone Joint. 2020;9(2):104-7. (in Chinese)
13.
go back to reference Wainwright TW, Gill M, McDonald DA, Middleton RG, Reed M, Sahota O, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS(®)) Society recommendations. Acta Orthop. 2020;91(1):3–19.CrossRef Wainwright TW, Gill M, McDonald DA, Middleton RG, Reed M, Sahota O, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS(®)) Society recommendations. Acta Orthop. 2020;91(1):3–19.CrossRef
14.
go back to reference Rissanen P, Aro S, Slätis P, Sintonen H, Paavolainen P. Health and quality of life before and after hip or knee arthroplasty. J Arthroplasty. 1995;10(2):169–75.CrossRef Rissanen P, Aro S, Slätis P, Sintonen H, Paavolainen P. Health and quality of life before and after hip or knee arthroplasty. J Arthroplasty. 1995;10(2):169–75.CrossRef
15.
go back to reference Liebs TR, Herzberg W, Rüther W, Haasters J, Russlies M, Hassenpflug J. Ergometer cycling after hip or knee replacement surgery: a randomized controlled trial. J Bone Joint Surg Ame. 2010;92(4):814–22.CrossRef Liebs TR, Herzberg W, Rüther W, Haasters J, Russlies M, Hassenpflug J. Ergometer cycling after hip or knee replacement surgery: a randomized controlled trial. J Bone Joint Surg Ame. 2010;92(4):814–22.CrossRef
16.
go back to reference Brydges CR. Effect size guidelines, sample size calculations, and statistical power in gerontology. Innov Aging. 2019;3(4):igz036.CrossRef Brydges CR. Effect size guidelines, sample size calculations, and statistical power in gerontology. Innov Aging. 2019;3(4):igz036.CrossRef
17.
go back to reference Cavanaugh A, Rauh MJ, Thompson CA, et al. Racial and ethnic disparities in utilization of total knee arthroplasty among older women. Osteoarthritis Cartilage. 2019;27(12):1746–54.CrossRef Cavanaugh A, Rauh MJ, Thompson CA, et al. Racial and ethnic disparities in utilization of total knee arthroplasty among older women. Osteoarthritis Cartilage. 2019;27(12):1746–54.CrossRef
18.
go back to reference Pan F, Tian J, Munugoda IP, Graves S, Lorimer M, Cicuttini F, et al. Do knee pain phenotypes have different risks of total knee replacement? J Clin Med. 2020;9:632.CrossRef Pan F, Tian J, Munugoda IP, Graves S, Lorimer M, Cicuttini F, et al. Do knee pain phenotypes have different risks of total knee replacement? J Clin Med. 2020;9:632.CrossRef
19.
go back to reference Lotke PA, Ecker ML, McCloskey J, Steinberg ME. Early experience with total knee arthroplasty. JAMA. 1976;236(21):2403–6.CrossRef Lotke PA, Ecker ML, McCloskey J, Steinberg ME. Early experience with total knee arthroplasty. JAMA. 1976;236(21):2403–6.CrossRef
20.
go back to reference Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606–17.CrossRef Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606–17.CrossRef
21.
go back to reference Ripollés-Melchor J, Abad-Motos A, Díez-Remesal Y, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in total hip and knee arthroplasty in the postoperative outcomes within enhanced recovery after surgery protocol in elective total hip and knee arthroplasty study (POWER2). JAMA Surg. 2020;155(4):e196024.CrossRef Ripollés-Melchor J, Abad-Motos A, Díez-Remesal Y, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in total hip and knee arthroplasty in the postoperative outcomes within enhanced recovery after surgery protocol in elective total hip and knee arthroplasty study (POWER2). JAMA Surg. 2020;155(4):e196024.CrossRef
22.
go back to reference Marques CJ, Bohlen K, Lampe F. Participation in a preoperative patient education session is a significant predictor of better WOMAC total index score and higher EQ-5D-5L health status index 1 year after total knee and hip arthroplasties: a retrospective observational study. Am J Phys Med Rehabil. 2021;100(10):972–7.CrossRef Marques CJ, Bohlen K, Lampe F. Participation in a preoperative patient education session is a significant predictor of better WOMAC total index score and higher EQ-5D-5L health status index 1 year after total knee and hip arthroplasties: a retrospective observational study. Am J Phys Med Rehabil. 2021;100(10):972–7.CrossRef
23.
go back to reference Weiwei K, Fan L, Leilei A, et al. Effects of multimode analgesia on acute pain after total knee arthroplasty and influence factors. Chin J Joint Surg (Electronic Version). 2019;13(2):255–60. Weiwei K, Fan L, Leilei A, et al. Effects of multimode analgesia on acute pain after total knee arthroplasty and influence factors. Chin J Joint Surg (Electronic Version). 2019;13(2):255–60.
24.
go back to reference Wenjiang S, Wei S, Bo Y, et al. Function of patients with osteosarcoma of the knee after tumor type prosthesis replacement and its influencing factors. Chin J Clin Health c. 2021;24(2):167–71. Wenjiang S, Wei S, Bo Y, et al. Function of patients with osteosarcoma of the knee after tumor type prosthesis replacement and its influencing factors. Chin J Clin Health c. 2021;24(2):167–71.
25.
go back to reference Qingbin D, Yanping J, Meihon C, et al. Level of hope and its influencing factors in elderly patients with total knee anthroplasty. Chin J Modern Nurs. 2019;25:3257–61. Qingbin D, Yanping J, Meihon C, et al. Level of hope and its influencing factors in elderly patients with total knee anthroplasty. Chin J Modern Nurs. 2019;25:3257–61.
26.
go back to reference Shaolong D, Bo K, Zhijun L. Influence factors of knee joint function rehabilitation after total knee arthroplasty in patients with knee osteoarthritis. J Xinxiang Med University. 2020;37(6):563–5. Shaolong D, Bo K, Zhijun L. Influence factors of knee joint function rehabilitation after total knee arthroplasty in patients with knee osteoarthritis. J Xinxiang Med University. 2020;37(6):563–5.
27.
go back to reference White L, Stockwell T, Hartnell N, Hennessy M, Mullan J. Factors preventing kneeling in a group of pre-educated patients post total knee arthroplasty. J Orthop Traumatol. 2016;17(4):333–8.CrossRef White L, Stockwell T, Hartnell N, Hennessy M, Mullan J. Factors preventing kneeling in a group of pre-educated patients post total knee arthroplasty. J Orthop Traumatol. 2016;17(4):333–8.CrossRef
28.
go back to reference Pua YH, Poon CL, Seah FJ, Thumboo J, Clark RA, Tan MH, et al. Predicting individual knee range of motion, knee pain, and walking limitation outcomes following total knee arthroplasty. Acta Orthop. 2019;90(2):179–86.CrossRef Pua YH, Poon CL, Seah FJ, Thumboo J, Clark RA, Tan MH, et al. Predicting individual knee range of motion, knee pain, and walking limitation outcomes following total knee arthroplasty. Acta Orthop. 2019;90(2):179–86.CrossRef
29.
go back to reference Kennedy D, Wainwright A, Pereira L, Robarts S, Dickson P, Christian J, et al. A qualitative study of patient education needs for hip and knee replacement. BMC Musculoskelet Disord. 2017;18(1):413.CrossRef Kennedy D, Wainwright A, Pereira L, Robarts S, Dickson P, Christian J, et al. A qualitative study of patient education needs for hip and knee replacement. BMC Musculoskelet Disord. 2017;18(1):413.CrossRef
30.
go back to reference Bletterman AN, de Geest-Vrolijk ME, Vriezekolk JE, et al. Preoperative psychosocial factors predicting patient’s functional recovery after total knee or total hip arthroplasty: a systematic review. Clin Rehabil. 2018;32(4):512–25.CrossRef Bletterman AN, de Geest-Vrolijk ME, Vriezekolk JE, et al. Preoperative psychosocial factors predicting patient’s functional recovery after total knee or total hip arthroplasty: a systematic review. Clin Rehabil. 2018;32(4):512–25.CrossRef
31.
go back to reference Moyer R, Ikert K, Long K, Marsh J. the value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis. JBJS Rev. 2017;5(12):e2.CrossRef Moyer R, Ikert K, Long K, Marsh J. the value of preoperative exercise and education for patients undergoing total hip and knee arthroplasty: a systematic review and meta-analysis. JBJS Rev. 2017;5(12):e2.CrossRef
Metadata
Title
Education level has an effect on the recovery of total knee arthroplasty: a retrospective study
Authors
Yuan-yuan Zhou
Bo-kai Zhang
Tian-fei Ran
Song Ke
Tian-ying Ma
Yin-yin Qin
Yuan Zhang
Yuan Xu
Min Wang
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05939-w

Other articles of this Issue 1/2022

BMC Musculoskeletal Disorders 1/2022 Go to the issue