Poor Outcomes following Primary Total Knee Replacement (TKR) - An Investigation into the Reason behind Why Some Perform Poorly 1-1.5 Years Post-TKR

Description

In this presentation, Abokor Mohamed, a fourth-year medical student at Cardiff University, discusses a study focused on the reasons for poor outcomes following primary total knee replacements (TKR). He highlights that, although 1.2 million total knee replacements are performed in the UK over a 15-year period, one in five patients remain dissatisfied with their procedure. He seeks to understand the discrepancies in patient satisfaction compared to higher satisfaction rates for hip replacements, questioning whether the dissatisfaction stems from preventable risks or unavoidable expectations.



During the study, conducted over nine years with specific patient criteria, the research team examined factors such as age, gender, BMI, and preoperative Oxford Knee Scores. They identified a bottom 10% of performers based on these scores, discovering that demographic information alone was not indicative of poor outcomes.



Key findings included that 31% of patients had anxiety or depression, 40% reported neuropathic pain post-surgery, and a notable 25% of patients went on to have bilateral knee replacements despite initial dissatisfaction. The presentation calls for further investigation into the reasons behind these dissatisfaction rates and the need for improved support and preoperative counseling to better manage patient expectations.



The discussion touches upon the importance of evaluating patients holistically, considering psychological factors and preparing for varied clinical outcomes, including the implications of preserved joint space observed in knee surgeries.

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