Quality of life after total knee replacement: a systematic literature review

Introduction: Recently there has been a rapid increase in the prevalence of arthritic knee disorders, resulting in a consequential increase in total knee replacement operations. At the same time, the mean age of people undergoing surgery is decreasing because people want to improve their life expectancy and be productive. Objective: We performed a systematic literature review to explore the quality of life of patients with total knee replacement. Material and method: A systematic literature review was conducted in PubMed and Cochrane Library using the following keywords: quality of life, health related quality of life, quality adjusted life year, patient report outcome, life satisfaction, total knee replacement, total knee arthroplasty, total knee joint prosthesis. From a total of 577 results of the scientific search, 20 studies met the inclusive criteria. Results: In four studies there were statistically significant correlation between disability, continued pain, quality of sleep, presence of negative emotions and obesity with deterioration in quality of life after total knee replacement. Three studies did not identify statistically significant correlations of pre-surgery wait, pre-surgery body mass index and the creation of a multidisciplinary rehabilitation program in the promotion of quality of life. However, thirteen surveys showed statistically significant improvements in quality of life. Specifically in two studies, there was a statistically significant improvement in the subjective dimension of quality of life, two studies found statistically more significant improvements in men than women, and eight studies found a statistically significant improvement in the quality of life for patients with rheumatic diseases, especially for patients with osteoarthritis. Conclusions: Patient quality of life is promoted after total knee replacement. However, when conducting research, it is necessary to investigate both the objective and the subjective dimensions pertaining to quality of life. The intensification of the investigation of the specific field of research can contribute to the upgrading of the quality of the services provided and to the timely identification of the complications that may arise from the increased implementation of total knee replacement.

Keywords: Quality of life, total knee replacement, systematic literature review