The Association Between Caregiver Support and Early Postoperative Outcomes after Total Knee Arthroplasty
Emin Can Balcı, Ismayil HajiyevBackground
Early postoperative recovery after total knee arthroplasty (TKA) shows considerable variability despite standardized surgical and rehabilitation protocols. Social support provided by caregivers may influence early pain control and functional recovery; however, its clinical impact has not been well quantified.
Purpose
To investigate the association between caregiver support and early postoperative pain and functional outcomes following primary unilateral TKA.
Methods
This retrospective observational study included 86 patients who underwent primary unilateral TKA performed by a single surgeon at a single tertiary referral center. All patients received standardized spinal anesthesia without regional nerve blocks or patient-controlled analgesia. Caregiver-related variables included the number of caregivers during hospitalization and at home, caregiver proximity, cohabitation status, and caregiver participation in physiotherapy. Pain was assessed using the Visual Analog Scale (VAS) at postoperative 2 weeks and 3 months. Functional outcomes included independent ambulation, stair climbing ability, and knee range of motion. Spearman correlation analyses and multivariable linear and logistic regression analyses with HC3 robust standard errors were performed.
Results
Mean VAS scores decreased from 3.67 ± 2.16 at 2 weeks to 2.00 ± 1.52 at 3 months postoperatively. A higher number of caregivers at home was independently associated with lower VAS scores at both time points and greater pain reduction over time (p < 0.05). A higher number of caregivers at home was also associated with a higher likelihood of stair climbing (OR = 15.44, p = 0.010). In contrast, a higher number of caregivers during hospitalization was associated with higher VAS scores at 2 weeks and a lower likelihood of stair climbing. Caregiver-related variables were not significantly associated with knee range of motion.
Conclusion
Greater caregiver support at home is associated with improved early postoperative pain control and functional independence following TKA. Caregiver availability in the home setting represents an important factor to consider in postoperative care planning.