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J Knee Surg 2021; 34(02): 200-207
DOI: 10.1055/s-0039-1694026
Original Article

Effectiveness of Using Photographs of the Change in Standing Posture on Postoperative Patient-Reported Satisfaction and Quality of Life

Abdulhamit Misir 
1   Department of Orthopedics and Traumatology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
,
Turan Bilge Kizkapan
2   Department of Orthopedics and Traumatology, Bursa Cekirge State Hospital, Bursa, Turkey
,
Suleyman Kasim Tas
3   Department of Orthopedics and Traumatology, Baltalimani Bone and Joint Diseases Training and Research Hospital, Istanbul, Turkey
,
Kadir Ilker Yildiz
3   Department of Orthopedics and Traumatology, Baltalimani Bone and Joint Diseases Training and Research Hospital, Istanbul, Turkey
,
Erdal Uzun
4   Department of Orthopedics and Traumatology, Ordu University School of Medicine, Ordu, Turkey
,
Mustafa Ozcamdalli
5   Department of Orthopedics and Traumatology, Ahi Evran University School of Medicine, Kirsehir, Turkey
› Author Affiliations Funding None.
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Abstract

Dissatisfaction is still an important problem in a small but important group of patients who undergo total knee arthroplasty. This study was designed to evaluate the effectiveness of showing patients the change in their standing posture, before and after total knee replacement, using standing photographs (anterior, posterior, and lateral view), on improving self-reported quality of life and satisfaction. Full-length lower extremity radiographs and standing photographs were obtained prior to total knee replacement and 6 months after surgery in the study group. In the control group, radiographs and photographs were not obtained. The hip–knee–ankle angle and mechanical axis deviation were compared between the two limbs and two groups. The changes in the following outcome measures were evaluated from baseline to 6 months after surgery: Short Form-36 Survey, Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, Oxford Knee Score, and Knee Society score. Postoperative measures were also compared before and after showing patients their standing photographs, and between two groups. The study and control groups included 71 and 44 patients, respectively, with unilateral or bilateral knee osteoarthritis (Kellgren–Lawrence Grade 3 or 4), with a mean age of 66 years. All patients had a varus malalignment, with significant improvement in postoperative limb alignment (p < 0.001). All self-reported outcome measures improved after surgery (p < 0.05), with the exception of mental health in the Short Form-36. Self-reported scores further improved after patients seeing their standing photographs (p < 0.05), with the exception of mental health and social role functioning. There were also significantly improved scores in the study group than control group after showing photographs (p < 0.05). Showing patients the pre-to-postoperative change in their standing posture might be an easy-to-administer method to improve patient satisfaction with the outcome of total knee replacement and self-reported quality of life. The Level of Evidence for this study is four.

Keywords

total knee replacement - body photograph - patient satisfaction - quality of life - outcome


Publication History

Received: 31 January 2019

Accepted: 28 June 2019

Article published online:
08 August 2019

© 2019. Thieme. All rights reserved.

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