Knee surgery recovery: Post-operative Quality of Recovery Scale comparison of age and complexity of surgery

Background Initial validation and feasibility for the Post-operative Quality of Recovery Scale (PQRS) was published in 2010. Ongoing validation includes studies to determine whether this scale can discriminate differences in recovery between cohorts. Methods A prospective cohort study included 61 patients, 18-40 years, and 61 patients, aged 65 years, undergoing knee arthroscopy under general anaesthesia; and 13 patients, aged 65 years, undergoing total knee replacement under general anaesthesia. Patients were assessed using the PQRS. Assessments were performed pre-surgery, at 15 and 40min, 1 and 3 days, and 3 months after surgery. Results The effect of age was assessed by comparing young versus older arthroscopy patients. There were minimal differences in recovery profiles, other than for the nociceptive domain, where pain recovery was significantly better in the older arthroscopy patients (P<0.001). The effect of surgery was assessed by comparing older patients undergoing knee arthroscopy with knee replacement patients. Recovery was significantly worse for the knee replacement group for cognition (P=0.015), nociception (pain and nausea, P<0.001), activities of daily living (P<0.001), emotive recovery (P=0.029), and all-domains recovery (P<0.001). Despite differences in quality of recovery, satisfaction was high in all cohorts. Conclusions Knee replacement had a large effect on recovery compared with knee arthroscopy. Age had minimal effect on recovery after knee arthroscopy. The study showed the ability of the PQRS to discriminate recovery in different domains.