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      The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty.

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          Abstract

          Satisfaction with the outcome of total knee arthroplasty is highly variable, with a small but significant percentage of patients reporting dissatisfaction with the procedure. The purpose of this study was to determine which factors contribute to patient satisfaction with total knee replacement (TKR), and their relative importance. At a minimum of 1 year post unilateral primary TKR, 253 patients completed a self-administered, validated "Knee Function Questionnaire," which examined each patient's participation in a broad range of activities involving the knee, their level of satisfaction, and the extent to which TKR had fulfilled their expectations. The association between function, expectation and satisfaction was examined using univariate and multivariate logistic regression. Seventy-five percent of patients were either "satisfied" or "very satisfied" with their knee replacement, while 14% were "dissatisfied" or "very dissatisfied." Satisfaction correlated significantly (p < 0.001) with age less than 60, absence of residual symptoms, fulfillment of expectations, and absence of functional impairment. Satisfaction with TKR is primarily determined by patients' expectations, and not their absolute level of function. Real improvements in the outcome of TKA must address prevention of residual pain, stiffness and swelling, and each patient's preoperative concept of the likely outcome of these procedures.

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          Author and article information

          Journal
          Clin Orthop Relat Res
          Clinical orthopaedics and related research
          Ovid Technologies (Wolters Kluwer Health)
          0009-921X
          0009-921X
          Nov 2006
          : 452
          Affiliations
          [1 ] Barnhart Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA. pnoble@bcm.tmc.edu
          Article
          10.1097/01.blo.0000238825.63648.1e
          16967035
          810fe2f3-ca99-4438-9972-f6f01834f929
          History

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