Skip to main content

Advertisement

SpringerLink
Log in

Knowledge and attitude towards total knee arthroplasty among the public in Saudi Arabia: a nationwide population-based study

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Studies on total knee arthroplasty (TKA) in Saudi Arabia are scarce, and none have reported the knowledge and attitude of the procedure in Saudi Arabia. Our study aims to measure the knowledge and attitude of TKA among the adult Saudi population.

Methods

To encompass a representative sample of this cross-sectional survey, all 13 administrative areas were used as ready-made geographical clusters. For each cluster, stratified random sampling was performed to maximize participation in the study. In each area, random samples of mobile phone numbers were selected with a probability proportional to the administrative area population size. Sample size calculation was based on the assumption that 50% of the participants would have some level of knowledge, with a 2% margin of error and 95% confidence level. To reach our intended sample size of 1540, we contacted 1722 participants with a response rate of 89.4%.

Results

The expected percentage of public knowledge was 50%; however, the actual percentage revealed by this study was much lower (29.7%). A stepwise multiple logistic regression was used to assess the factors that positively affected the knowledge score regarding TKA. Age [P = 0.016 with OR of 0.47], higher income [P = 0.001 with OR of 0.52] and participants with a positive history of TKA or that have known someone who underwent the surgery [P < 0.001 with OR of 0.15] had a positive impact on the total knowledge score.

Conclusions

There are still misconceptions among the public in Saudi Arabia concerning TKA, its indications and results. We recommend that doctors use the results of our survey to assess their conversations with their patients, and to determine whether the results of the procedure are adequately clarified.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harris WH, Sledge CB (1990) Total hip and total knee replacement (2). N Engl J Med 323:801–807. https://doi.org/10.1056/NEJM199009203231206

    Article  CAS  PubMed  Google Scholar 

  2. Singh JA (2011) Epidemiology of knee and hip arthroplasty: a systematic review. Open Orthop J 5:80–85. https://doi.org/10.2174/1874325001105010080

    Article  PubMed  PubMed Central  Google Scholar 

  3. Skou ST, Roos EM, Laursen MB et al (2015) A randomized, controlled trial of total knee replacement. N Engl J Med 373:1597–1606. https://doi.org/10.1056/NEJMoa1505467

    Article  CAS  PubMed  Google Scholar 

  4. Saragaglia D, Sigwalt L, Gaillot J et al (2017) Results with eight and a half years average follow-up on two hundred and eight e-motion FP(R) knee prostheses, fitted using computer navigation for knee osteoarthritis in patients with over ten degrees genu varum. Int Orthop. https://doi.org/10.1007/s00264-017-3618-8

  5. Schiavone Panni A, Falez F, D’Apolito R et al (2017) Long-term follow-up of a non-randomised prospective cohort of one hundred and ninety two total knee arthroplasties using the NexGen implant. Int Orthop 41:1155–1162. https://doi.org/10.1007/s00264-017-3438-x

    Article  PubMed  Google Scholar 

  6. Austin TW, Austin MA, Coleman B et al (2004) Total knee replacement surgery and surgical site infection: a prospective audit. Can J Surg 47:145

    PubMed  PubMed Central  Google Scholar 

  7. Jacobs CA, Christensen CP (2014) Factors influencing patient satisfaction two to five years after primary total knee arthroplasty. J Arthroplast 29:8–10. https://doi.org/10.1016/j.arth.2014.01.008

    Google Scholar 

  8. Maratt JD, Lee Y-Y, Lyman S, Westrich GH (2015) Predictors of satisfaction following Total knee Arthroplasty. J Arthroplast 30:1142–1145. https://doi.org/10.1016/j.arth.2015.01.039

    Article  Google Scholar 

  9. Apold H, Meyer HE, Nordsletten L et al (2014) Risk factors for knee replacement due to primary osteoarthritis, a population based, prospective cohort study of 315,495 individuals. BMC Musculoskelet Disord 15:217. https://doi.org/10.1186/1471-2474-15-217

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kim H, Kim S, Seo YI et al (2008) The epidemiology of total knee replacement in South Korea: national registry data. Rheumatology (Oxford) 47:88–91. https://doi.org/10.1093/rheumatology/kem308

    Article  Google Scholar 

  11. Mahomed NN, Barrett J, Katz JN et al (2005) Epidemiology of total knee replacement in the United States Medicare population. J Bone Joint Surg Am 87:1222–1228. https://doi.org/10.2106/JBJS.D.02546

    PubMed  Google Scholar 

  12. Cram P, Lu X, Kates SL et al (2012) Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991-2010. JAMA 308:1227. https://doi.org/10.1001/2012.jama.11153

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Kurtz S, Ong K, Lau E et al (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89:780–785. https://doi.org/10.2106/JBJS.F.00222

    PubMed  Google Scholar 

  14. Jain NB, Higgins LD, Ozumba D et al (2005) Trends in epidemiology of knee arthroplasty in the United States, 1990-2000. Arthritis Rheum 52:3928–3933. https://doi.org/10.1002/art.21420

    Article  PubMed  Google Scholar 

  15. Kwoh CK, Vina ER, Cloonan YK et al (2015) Determinants of patient preferences for total knee replacement: African-Americans and whites. Arthritis Res Ther 17:348. https://doi.org/10.1186/s13075-015-0864-2

    Article  PubMed  PubMed Central  Google Scholar 

  16. Al-Omran AS (2014) The quality of life (QOL) after total knee arthroplasties among Saudi Arabians: a pilot study. Int J Biomed Sci 10:196–200

    PubMed  PubMed Central  Google Scholar 

  17. Behairy YM, Motuweh SH, Kathlan KA (2004) A survey of patients’ attitude toward total knee replacement in a major center in the Kingdom of Saudi Arabia. Saudi Med J 25:1291–1293

    PubMed  Google Scholar 

  18. Al-Taiar A, Al-Sabah R, Elsalawy E et al (2013) Attitudes to knee osteoarthritis and total knee replacement in Arab women: a qualitative study. BMC Res Notes 6:406. https://doi.org/10.1186/1756-0500-6-406

    Article  PubMed  PubMed Central  Google Scholar 

  19. Statistical Yearbook of 2015 (2015) Population in riyadh region by gender, age groups and nationality 2015. General Authority for Statistics. https://www.stats.gov.sa/en/3134. Accessed 1 March 2016

  20. Al-Arfaj AS, Alballa SR, Al-Saleh SS et al (2003) Knee osteoarthritis in al-Qaseem, Saudi Arabia. Saudi Med J 24:291–293

    PubMed  Google Scholar 

  21. Carr AJ, Robertsson O, Graves S et al (2012) Knee replacement. Lancet 379:1331–1340. https://doi.org/10.1016/S0140-6736(11)60752-6

    Article  PubMed  Google Scholar 

  22. Bedson J, Mottram S, Thomas E, Peat G (2007) Knee pain and osteoarthritis in the general population: what influences patients to consult? Fam Pract 24:443–453. https://doi.org/10.1093/fampra/cmm036

    Article  PubMed  Google Scholar 

  23. Prasanna SS, Korner-Bitensky N, Ahmed S (2013) Why do people delay accessing health care for knee osteoarthritis? Exploring beliefs of health professionals and lay people. Physiother Can 65:56–63. https://doi.org/10.3138/ptc.2011-50

    Article  PubMed  PubMed Central  Google Scholar 

  24. Weinstein AM, Rome BN, Reichmann WM et al (2013) Estimating the burden of total knee replacement in the United States. J Bone Joint Surg Am 95:385–392. https://doi.org/10.2106/JBJS.L.00206

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hepinstall MS, Rutledge JR, Bornstein LJ et al (2011) Factors that impact expectations before total knee arthroplasty. J Arthroplast 26:870–876. https://doi.org/10.1016/j.arth.2010.09.010

    Article  Google Scholar 

  26. Mancuso CA, Sculco TP, Salvati EA (2003) Patients with poor preoperative functional status have high expectations of total hip arthroplasty. J Arthroplast 18:872–878. https://doi.org/10.1016/S0883-5403(03)00276-6

    Article  Google Scholar 

  27. Yoo JH, Chang CB, Kang YG et al (2011) Patient expectations of total knee replacement and their association with sociodemographic factors and functional status. J Bone Joint Surg Br 93:337–344. https://doi.org/10.1302/0301-620X.93B3.25168

    Article  CAS  PubMed  Google Scholar 

  28. Youm J, Chan V, Belkora J, Bozic KJ (2015) Impact of socioeconomic factors on informed decision making and treatment choice in patients with hip and knee OA. J Arthroplast 30:171–175. https://doi.org/10.1016/j.arth.2014.09.006

    Article  Google Scholar 

  29. Greene ME, Rolfson O, Nemes S et al (2014) Education attainment is associated with patient-reported outcomes: findings from the Swedish hip arthroplasty register. Clin Orthop Relat Res 472:1868–1876. https://doi.org/10.1007/s11999-014-3504-2

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hawker GA, Wright JG, Glazier RH et al (2002) The effect of education and income on need and willingness to undergo total joint arthroplasty. Arthritis Rheum 46:3331–3339. https://doi.org/10.1002/art.10682

    Article  PubMed  Google Scholar 

  31. Shemesh SS, Bronson MJ, Moucha CS (2016) Computer-assisted total knee arthroplasty marketing and patient education: an evaluation of quality, content and accuracy of related websites. Int Orthop 40:2003–2009. https://doi.org/10.1007/s00264-016-3215-2

    Article  PubMed  Google Scholar 

  32. Voigt LF, Schwartz SM, Doody DR et al (2011) Feasibility of including cellular telephone numbers in random digit dialing for epidemiologic case-control studies. Am J Epidemiol 173:118–126. https://doi.org/10.1093/aje/kwq322

    Article  PubMed  Google Scholar 

  33. Memish ZA, El Bcheraoui C, Tuffaha M et al (2014) Obesity and associated factors--Kingdom of Saudi Arabia, 2013. Prev Chronic Dis 11:E174. https://doi.org/10.5888/pcd11.140236

    PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors would like to duly express their heart-felt appreciation and gratitude to Dr. Mahmoud S. Mahmoud for proof reading this manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

    Omar A. Al-Mohrej

  2. Department of Emergency Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Faris O. Alshammari

  3. Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    Abdulrahman M. Aljuraisi & Emad M. Masuadi

  4. Department of Health Education, College of Health and Rehabilitation, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia

    Lujain A. Bin Amer

  5. Department of Orthopaedics, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Nader S. Al-Kenani

Authors
  1. Omar A. Al-Mohrej
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Faris O. Alshammari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdulrahman M. Aljuraisi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lujain A. Bin Amer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Emad M. Masuadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nader S. Al-Kenani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Omar A. Al-Mohrej.

Ethics declarations

Competing interests

The authors have declared that no competing interests exist.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The present study was approved by the Institutional Review Board (IRB) at King Abdullah Medical International Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia Protocol Number of SP15/162.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al-Mohrej, O.A., Alshammari, F.O., Aljuraisi, A.M. et al. Knowledge and attitude towards total knee arthroplasty among the public in Saudi Arabia: a nationwide population-based study. International Orthopaedics (SICOT) 42, 819–827 (2018). https://doi.org/10.1007/s00264-017-3743-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-017-3743-4

Keywords

Search

Navigation