Patient Satisfaction after Total Knee Arthroplasty: Who is Satisfied and Who is Not?

• Published in: Clinical orthopaedics and related research 2010-01, Vol.468 (1), p.57-63
• Main Authors: Bourne, Robert B., Chesworth, Bert M., Davis, Aileen M., Mahomed, Nizar N., Charron, Kory D. J.
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - psychology; Arthroplasty, Replacement, Knee - rehabilitation; Biological and medical sciences; Conservative Orthopedics; Cross-Sectional Studies; Disability Evaluation; Diseases of the osteoarticular system; Female; Health Status Indicators; Humans; Knee Joint - physiopathology; Knee Joint - surgery; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Ontario - epidemiology; Orthopedic surgery; Orthopedics; Pain - epidemiology; Pain - psychology; Pain - rehabilitation; Patient Satisfaction - statistics & numerical data; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Range of Motion, Articular; Recovery of Function; Sports Medicine; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Orthopedics; Surveys and Questionnaires; Symposium: Papers Presented at the Annual Meetings of the Knee Society; Treatment Outcome
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-009-1119-9

Despite substantial advances in primary TKA, numerous studies using historic TKA implants suggest only 82% to 89% of primary TKA patients are satisfied. We reexamined this issue to determine if contemporary TKA implants might be associated with improved patient satisfaction. We performed a cross-sectional study of patient satisfaction after 1703 primary TKAs performed in the province of Ontario. Our data confirmed that approximately one in five (19%) primary TKA patients were not satisfied with the outcome. Satisfaction with pain relief varied from 72–86% and with function from 70–84% for specific activities of daily living. The strongest predictors of patient dissatisfaction after primary TKA were expectations not met (10.7× greater risk), a low 1-year WOMAC (2.5× greater risk), preoperative pain at rest (2.4× greater risk) and a postoperative complication requiring hospital readmission (1.9× greater risk). Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.