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Journal Article


Sindhupakorn B, Numpaisal PO, Thienpratharn S, Jomkoh D. J. Orthop. Surg. Res. 2019; 14(1): e405.


School of orthopedic, Institute of medicine, Suranaree University of Technology, 111 University Ave, Muang District, Nakhon Ratchasima, Nakhon Ratchasima, 30000, Thailand.


(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group - BMC)






BACKGROUND: The goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life. Surgical outcomes were not related to patients' satisfaction. Low 1-year WOMAC especially in the first 6 weeks and painful TKR related to patient dissatisfied. To improve satisfaction, we created the home visit program (TKR-H) after hospital discharge. INHOMESSS was the rationale for home visit activities.

METHODS: We recruited 52 TKRs. Four TKRs were excluded. We used simple randomization for 24 patients as a home visit (TKR-H) and 24 patients as a non-home visit (TKR). Patients were evaluated by general demographics, pain intensity scores (VAS), range of motion (ROM), WOMAC, knee scores, and functional scores as a primary objective. A duration for gait aid independent and patient's satisfaction score as secondary objective. The study was 6 weeks after surgery.

RESULTS: TKR-H and TKR had significant differences in the mean of WOMAC score (88.29 ± 10.66 vs. 68.00 ± 12.47, respectively, P <  0.001), pain score (VAS) (6.25 ± 10.13 vs. 35.67 ± 22.05, respectively, P <  0.001), knee score (81.67 ± 10.08 vs. 68.38 ± 6.45, respectively, P <  0.001), functional score (77.83 ± 4.22 vs. 73.70 ± 7.48, respectively, P = 0.037), and range of motion (107.71 ± 8.47 vs. 98.17 ± 9.57, respectively, P = 0.001). The patient's satisfaction score in TKR-H group (4.71 ± 0.46) was significantly higher than the TKR group (4.13 ± 0.45) (P <  0.001) and time to gait aid independent (2.75 ± 0.99 vs. 3.71 ± 1.23, respectively, P = 0.005).

CONCLUSION: Our TKR-H showed better clinical outcomes and satisfaction than non-home visit. The rationale in TKR-H improves satisfaction after total knee replacement. TRIAL REGISTRATION: TCTR20190514001.

Language: en


Home visit program; Non-home visit program; Total knee replacement


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