Publication

Differences in case mix and outcomes between Swiss and Scottish total knee arthroplasty patients

Journal Paper/Review - Jul 2, 2019

Units
Keywords
PubMed
Doi
Link
Contact

Citation
Giesinger J, Giesinger K, Federico B, Howie C, Hamilton D. Differences in case mix and outcomes between Swiss and Scottish total knee arthroplasty patients. Knee Surg Sports Traumatol Arthrosc 2019; 28:1797-1804.
Project
Type
Journal Paper/Review (English)
Journal
Knee Surg Sports Traumatol Arthrosc 2019; 28
Publication Date
Jul 2, 2019
Issn Print
Issn Electronic
1433-7347
Pages
1797-1804
Publisher
Brief description/objective

PURPOSE
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.