Determining the Effect of Deprivation on Quality of Life after Total and Unicompartmental Knee Arthroplasty

Abstract

Determining the effect of deprivation on quality of life after total and unicompartmental knee arthroplasty Quality of life (QoL) following joint replacement is now a national priority, with every patient being assessed using the Oxford Knee Score. The current literature is conflicted as to whether deprivation has any effect on outcome after knee surgery. The type of surgery is another variable that may determine outcome. We set out to investigate which of these factors was a more powerful predictor of outcome. A prospective trial began where, 68 patients were telephoned, (30 TKA’s and 38 UKA’s). Each were asked a series of questions comprising the Oxford Knee Score (post operation), Imperial Knee Score (post operation), EuroQol-5D (pre and post operation) and individual deprivation questions. This was compared with the deprivation status using Townsend scores. A comparison of total and unicompartmental outcomes were also analysed including cost-effectiveness. No correlation was found between outcome and Townsend scores (p < 0.05). Age was seen to be a significant indicator of pre surgical QoL. However, a large and significant difference was found between UKA and TKA when using the EQ-5D (p < 0.05) and the Imperial Knee Score (p < 0.09). This was not reflected in the Oxford Knee Score. UKA’s were also found to be more cost-effective than TKA’s. Deprivation has no major effect on the outcome of knee surgery in London. A clear difference in efficacy exists between TKA’s and UKA’s. Sensitivity of scores needs to be addressed.