Patient-reported short to medium term functional outcome following Total Knee Replacement: An Oxford Knee Score-based observational study in a tertiary care hospital

Abstract

Background  Total knee replacement (TKR) is a well-established surgical intervention for patients with advanced knee arthritis. While clinical, radiological outcomes and patient symptoms are routinely assessed during their visits. Patient-reported outcome measures (PROMs) are less commonly assessed. The PROMs will provide valuable insights into postoperative functional status and quality of life. The Oxford Knee Score (OKS) is one such validated PROM tool for patients who have undergone knee replacements.

Objective To evaluate patient-reported functional outcomes following total knee replacement using the Oxford Knee Score among patients who had undergone TKR surgery.

Methods This observational cohort study included patients diagnosed with knee arthritis who underwent unilateral or bilateral total knee replacement between January 2022 and December 2024. Oxford Knee Scores were collected through structured telephonic interviews conducted by an independent assessor who is not involved in the care of the patients. Appropriate informed consent was obtained. Orthopedic Surgeons and doctors involved in the care of the patients were not involved in the collection of the data to rule out bias. Standard data such as demographic characteristics, year of surgery, and laterality of surgery were recorded. Outcomes were analyzed descriptively using Oxford Knee Score categories.

Results A total of 90 patients (116 knees) underwent total knee replacement during the study period (2022 to 2024). Four patients died during follow-up unrelated to the surgery, one patient developed postoperative infection, four were lost to follow-up, and one declined participation even though doing well after the surgery due to an untoward reason. Hence, these 10 patients were excluded from the data collection and analysis for the purpodr of the study. 80 patients (103 knees) completed follow-up and were included in the final analysis. The mean age was 63.2 years (range: 30–82 years), with a female predominance (80%). Unilateral TKR was performed in 57 patients, while 23 patients underwent bilateral procedures. Based on the Oxford Knee Score, 85% of patients achieved treatment success, while 15% required further evaluation. According to the Kalairajah grading system, outcomes were excellent in 42.5%, good in 38.5%, fair in 13.8%, and poor in 5% of patients.