Background/Purpose: Patient satisfaction about health care experience has emerged, as a surrogate of quality of care. The Patient Protection and Affordable Care Act has allowed patient satisfaction data to help determine Medicare reimbursement. The use of US guidance for the injection and aspiration of joints has improved accuracy.¹ The aim of this study was to determine if differences exist in the level of patient satisfaction, functionality and quality of life in adult patients receiving US guided (USG) versus landmark guided (LMG) knee procedures.   

Methods: This prospective, randomized study enrolled 40 patients undergoing knee procedures to USG or LMG groups. Visual analogue scale (VAS) for pain, Knee injury and Osteoarthritis Outcome Score (KOOS) and patient satisfaction score on 5 point Likert scale were measured pre-procedure, immediate (<30 mins) and late (2-4 weeks) post-procedure. Mann-Whitney U test and ANOVA were used to compare continuous variables and chi-square test was used for categorical variables.  

Results: 37 patients were included in the final analysis after exclusion of 3 dropouts (18 in LMG arm, 19 in USG arm).  There were no significant differences between patients getting LMG or USG procedures with respect to age, sex, race, ethnicity, pre-procedural VAS pain and pre-procedural KOOS scores (Table 1). Patients in both groups had significant decrease in pain immediately and later post-procedure. Those in the USG group had significantly better improvement in pain and satisfaction at both the end points. Patients getting USG procedures reported significantly better KOOS scores (Pain, Symptoms, Activities of daily living, Sports-recreation & Quality of life) at 2-4 weeks (Figure 1, 2).  

Conclusion: USG knee procedures were associated with higher patient satisfaction, both immediately after the procedure and after 2-4 weeks. USG knee procedures resulted in greater improvement in symptoms, pain and quality of life scales after 2-4 weeks as compared to LMG knee procedures. In a time when patient satisfaction is increasingly important for insurance reimbursement, our study supports not only better quantitative outcomes with pain and function, but also greater patient satisfaction with USG knee procedures.   Reference: 1. Cunnington J et al. Arthritis and rheumatism. Jul 2010;62(7):1862-1869.