Quality of life after total knee arthroplasty: systematic review

Rev Bras Ortop. 2014 Sep 19;49(5):520-7. doi: 10.1016/j.rboe.2014.09.007. eCollection 2014 Sep-Oct.

Abstract

Objective: To review the literature on quality of life among patients who underwent total knee arthroplasty (TKA) and assess the impact of various associated factors.

Methods: this was a systematic review of the literature in the Medline, Embase, Lilacs and SciELO databases, using the terms: TKA (total knee arthroplasty); TKR (total knee replacement); quality of life; and outcomes. There were no restrictions regarding study design.

Results: 31 articles addressing this topic using various quality-of-life evaluation protocols were selected. SF-36/SF-12, WOMAC and Oxford were the ones most frequently used. The studies made it possible to define that TKA is capable of making an overall improvement in patients' quality of life. Pain and function are among the most important predictors of improvement in quality of life, even when function remains inferior to that of healthy patients.

Conclusion: The factors associated negatively were obesity, advanced age, comorbidities, persistence of pain after the procedure and a lengthy wait for surgery.

Objetivo: Revisar a literatura sobre qualidade de vida em pacientes submetidos a artroplastia total de joelho (ATJ) e avaliar o impacto de diversos fatores associados.

Métodos: Revisão sistemática da literatura nos bancos de dados Medline, Embase, Lilacs e Scielo, com os termos: TKA (total knee arthroplasty); TKR (total knee replacement); quality of life; e outcomes. Não houve restrições quanto ao desenho do estudo.

Resultados: Foram selecionados 31 artigos que abordavam o tema com vários protocolos de avaliação de qualidade de vida. SF-36/SF-12, Womac e Oxford foram os mais frequentes. Os estudos permitiram definir que a ATJ é capaz de melhorar globalmente a qualidade de vida dos pacientes. Dor e função estão entre os mais importantes preditores de melhoria da QV, mesmo quando a função permanece inferior à de pacientes saudáveis.

Conclusão: Os fatores associados negativamente foram obesidade, idade avançada, comordidades, persistência de dor após o procedimento e espera demorada pela cirurgia.

Keywords: Knee arthroplasty; Quality of life; Results assessment (healthcare).