Does Marital Status Impact Outcomes After Total Knee Arthroplasty?

Abstract

Background: There is a paucity of research on the relationship between marital status and patient outcomes following total knee arthroplasty (TKA).

Methods: This was a retrospective chart review of patients who underwent TKA by a single surgeon at a university-based orthopedic practice. Data abstracted included age, gender, marital status, body mass index, length of hospital stay, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Oxford Knee Score (OKS). The WOMAC and OKS were administered at the preoperative visit and at approximately 10, 30, 90, and 180 days after TKA. Multivariate analyses with patient-reported outcomes as repeated measures, marital status, day of assessment; and the interaction of marital status and day of assessment as fixed effects; and age, gender, body mass index, and length of hospital stay as covariates were conducted as well as analyses in which preoperative patient-reported outcomes were treated as fixed effects.

Results: Of 422 patients who underwent TKA during the study period, complete data were available for 249, of whom 124 were married and 125 unmarried. Married patients had significantly higher WOMAC scores than unmarried patients at all postoperative assessments, even after controlling for preoperative scores. Although married patients also had significantly higher postoperative OKS scores than their unmarried peers, differences between groups were attenuated after adjusting for preoperative OKS scores.

Conclusion: This study found that married patients have better overall outcomes after TKA but yielded conflicting results as to whether the positive effects of marriage are specific to the postoperative period.

Keywords: function; marital status; outcomes; pain; social support; total knee arthroplasty.