QUALITY-OF-LIFE AFTER KNEE ARTHROPLASTY - A RANDOMIZED STUDY OF 3 DESIGNS IN 42 PATIENTS, COMPARED AFTER 4 YEARS

We assessed different yardsticks for outcome 4 (3-5) years after surge ry in a prospective, randomized study of 42 patients, where 3 designs of cementless knee prostheses were used. The prognosis with regard to loosening, previously obtained by radiostereometry after 2 years of fo llow-up, was utilized. Patients with a prognosis of stable implant fix ation (two thirds) were compared with those where loosening was predic ted (one third), Hospital for Special Surgery score and Visual Analogu e Scales regarding pain at rest, ''first step'' pain, pain during acti vity and global function, showed consistent postoperative improvements , but no differences between the design and prognosis groups were foun d. Radiolucent lines were registered both as yes/no and number of zone s. Lines and prognosis were associated, but not lines and design group s. Quality of life assessment by the Nottingham Health Profile questio nnaire showed that the poor prognosis group had increased pain and sig nificant disturbances of sleep and emotions, as well as difficulty in enjoying hobbies and holiday activities. No differences were found bet ween the design groups. Altogether, the patients showed profiles compa rable to a healthy reference group. We conclude that the Nottingham He alth Profile is a sensitive, relevant and simple measure of outcome af ter knee arthroplasty.