Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?
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 (10.7x greater risk), a low 1-year WOMAC (2.5x greater risk), preoperative pain at rest (2.4x greater risk) and a postoperative complication requiring hospital readmission (1.9x greater risk).


METHODS
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
University Hospital, London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, ON N6A 5A5, Canada. robert.bourne@lhsc.on.ca
Robert B
RB
Bourne
Bert M
BM
Chesworth
Aileen M
AM
Davis
Nizar N
NN
Mahomed
Kory D J
KD
Charron
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000523:psychology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D016059:Range of Motion, Articular; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome