Health related quality of life in patients having total knee replacement and associations with symptoms, recovery, and patient education: a six month follow up study

Abstract Aim Describe symptoms, recovery, patient education, and health related quality of life (HRQOL) in patients having total knee replacements at three time points; detect experiences and situations that predict HRQOL six weeks and six months post-surgery. Method This was a prospective explorative two site study assessing 123 patients, at hospital (T1), six weeks (T2), and six months (T3) post-discharge. HRQOL was measured with SF-36v2 and symptoms were measured with the Hospital and Anxiety Scale, with two questions on pain and two on movement and tiredness. Two questions addressed recovery and patient education. Linear regression models were used to calculate predictors of mental and physical HRQOL at T2 and T3. Results In general, HRQOL improved from T1 to T3. Main predictors of higher physical scores at T2 were being older, fewer symptoms of depression and little distress related to movement. At T3 these were having resumed work, finding patient education very useful, experiencing no pain last 24 hours and fewer symptoms of depression. Main predictors of higher mental scores at T2 were fewer symptoms of anxiety and depression and little distress related to movement. At T3 these were fewer symptoms of anxiety and depression and experiencing no pain last 24 hours. Conclusion Apart from pain, function and resumption of activities, symptoms of anxiety and depression influence HRQOL. These symptoms should be assessed during hospital stay.