Abstract
BackgroundThe goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life. Surgical outcomes were not related to patients’ satisfaction. Low 1-year WOMAC especially in the first 6 weeks and painful TKR related to patient dissatisfied. To improve satisfaction, we created the home visit program (TKR-H) after hospital discharge. INHOMESSS was the rationale for home visit activities.MethodsWe recruited 52 TKRs. Four TKRs were excluded. We used simple randomization for 24 patients as a home visit (TKR-H) and 24 patients as a non-home visit (TKR). Patients were evaluated by general demographics, pain intensity scores (VAS), range of motion (ROM), WOMAC, knee scores, and functional scores as a primary objective. A duration for gait aid independent and patient’s satisfaction score as secondary objective. The study was 6 weeks after surgery.ResultsTKR-H and TKR had significant differences in the mean of WOMAC score (88.29 ± 10.66 vs. 68.00 ± 12.47, respectively, P < 0.001), pain score (VAS) (6.25 ± 10.13 vs. 35.67 ± 22.05, respectively, P < 0.001), knee score (81.67 ± 10.08 vs. 68.38 ± 6.45, respectively, P < 0.001), functional score (77.83 ± 4.22 vs. 73.70 ± 7.48, respectively, P = 0.037), and range of motion (107.71 ± 8.47 vs. 98.17 ± 9.57, respectively, P = 0.001). The patient’s satisfaction score in TKR-H group (4.71 ± 0.46) was significantly higher than the TKR group (4.13 ± 0.45) (P < 0.001) and time to gait aid independent (2.75 ± 0.99 vs. 3.71 ± 1.23, respectively, P = 0.005).ConclusionOur TKR-H showed better clinical outcomes and satisfaction than non-home visit. The rationale in TKR-H improves satisfaction after total knee replacement.Trial registrationTCTR20190514001.
Highlights
The goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life
We found no studies that focus on home visits after TKR, especially with the surgeon as the team leader of the home visit team
The patient satisfaction after TKR is associated with patient expectations, pain relief, and functional improvements
Summary
The goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life. Surgical outcomes were not related to patients’ satisfaction. Low 1-year WOMAC especially in the first 6 weeks and painful TKR related to patient dissatisfied. We created the home visit program (TKR-H) after hospital discharge. The keys to success for a total knee replacement (TKR) include reducing pain, restoring function, and improving the quality of life [1,2,3]. Due to the increase in knee replacements worldwide, there is an increasing focus on improving the cost and effectiveness of this procedure with healthcare systems. Several authors [12, 13] have compared rehabilitation programs in the hospital with those at home after a TKR and have found no differences in the functional outcomes. We found no studies that focus on home visits after TKR, especially with the surgeon as the team leader of the home visit team
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