Differences in case mix and outcomes between Swiss and Scottish total knee arthroplasty patients
Differences in case mix and outcomes between Swiss and Scottish total knee arthroplasty patients (Springer).
The clinical benefits of total knee arthroplasty (TKA) are well defined, but little attention has been paid to the cross-cultural variation. The objective of this study was to compare
case mix and outcomes following TKA in Swiss and Scottish patients.
Methods
Data from local registries at a Swiss and a Scottish orthopaedic hospital were
extracted to evaluate: (A) age, sex, body mass index (BMI), self-reported
health status (EQ-5D), and joint awareness (Forgotten Joint Score-12 (FJS-12))
at pre-surgery, (B) improvement in EQ-5D and FJS-12 scores from pre-surgery to
1 year, and (C) patient satisfaction at 1 year.
Results
Data from 2075 Swiss and 994 Scottish TKA patients were available from the
local registries. Swiss and Scottish patients differed in age (69.3 vs 68.8
years, p = 0.046), sex ratio (62.9% vs 56.9% women, p = 0.002) and BMI (29.6 vs
30.9, p < 0.001). At pre-surgery, FJS-12 scores were comparable (Swiss 12.1 vs
Scottish 10.9, n.s.), but EQ-5D scores were better in Swiss patients (0.52 vs
0.40, p < 0.001). Post-operative improvement was greater in Switzerland for the
FJS-12 (+ 55.1 vs + 32.2, p < 0.001), but not for the EQ-5D (+ 0.31 vs + 0.29,
n.s.). The satisfaction rate was similar in both groups (88.3% vs 89.6%,
n.s.).
Conclusion
Subtle cross-cultural variation was evident in TKA case-mix factors between the
two countries. Satisfaction and improvement in health status were similar,
while improvement in joint-specific outcome was notably greater in Switzerland.
Understanding cross-cultural variability of the outcome has important
implications when interpreting study and registry data from other countries and
when counselling a patient in daily practice.
Level of evidence
Retrospective cohort, Level III.
Keywords
Total knee arthroplasty Comparative study Patient-reported outcome Forgotten
Joint Score-12 EQ-5D Cross-cultural
Quelle: Springer, 02.07.2019
