title: Functional capacity and actual daily activity do not contribute to patient satisfaction after total knee arthroplasty.
abstract: BACKGROUND
  After total knee arthroplasty (TKA) only 75-89% of patients are satisfied. Because patient satisfaction is a prime goal of all orthopaedic procedures, optimization of patient satisfaction is of major importance. Factors related to patient satisfaction after TKA have been explored, but no studies have included two potentially relevant factors, i.e. the functional capacity of daily activities and actual daily activity. This present prospective study examines whether functional capacity and actual daily activity (in addition to an extensive set of potential factors) contribute to patient satisfaction six months after TKA.
  
  
  METHODS
  A total of 44 patients were extensively examined preoperatively and six months post surgery. Functional capacity was measured with three capacity tests, focusing on walking, stair climbing, and chair rising. Actual daily activity was measured in the patient's home situation by means of a 48-hour measurement with an Activity Monitor. To establish which factors were related to patient satisfaction six months post surgery, logistic regression analyses were used to calculate odds ratios.
  
  
  RESULTS
  Preoperative and postoperative functional capacity and actual daily activity had no relation with patient satisfaction. Preoperatively, only self-reported mental functioning was positively related to patient satisfaction. Postoperatively, based on multivariate analysis, only fulfilled expectations regarding pain and experienced pain six months post surgery were related to patient satisfaction.
  
  
  CONCLUSIONS
  Functional capacity and actual daily activity do not contribute to patient satisfaction after TKA. Patients with a better preoperative self-reported mental functioning, and patients who experienced less pain and had fulfilled expectations regarding pain postoperatively, were more often satisfied.
authors.affiliation: Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands. m.m.vissers@erasmusmc.nl
authors.forename: Maaike M
authors.initials: MM
authors.lastname: Vissers
authors.forename: Ingrid B
authors.initials: IB
authors.lastname: de Groot
authors.forename: Max
authors.initials: M
authors.lastname: Reijman
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Bussmann
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.forename: Jan An
authors.initials: JA
authors.lastname: Verhaar
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000453:epidemiology / Q000523:psychology; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000534:rehabilitation*; D015984:Causality; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome