title: [What do patients in Germany expect from their total knee arthroplasty?].
abstract: BACKGROUND
  Only 84 % of patients are satisfied with the operative result after total knee arthroplasty. A relevant reason is non-fulfilled preoperative expectations. Non-fulfilled preoperative expectations cannot be influenced postoperatively. So a knowledge of preoperative expectations and their influential factors is essential. The following study analyses the expectations and influential factors in patients before total knee arthroplasty in Germany.
  
  
  METHODS
  On the day before total knee replacement in 104 patients the following data were collected: school leaving level, comorbidities, articular knee function, psychological mood, health-related quality of life, and preoperative expectations. Statistical evaluation was done by factor analyses of expectations and independent variables, and correlation and regression analyses.
  
  
  RESULTS
  The following 4 factors of expectations resulted from the factor analyses: (i) relief of pain, (ii) increase of range of motion of the knee, (iii) better mobility, and (iv) better integration in social activities. In general patient expectations on the effects of a total knee replacement are high. Age and better integration in social activities correlate negatively, as also do age and better mobility. Body mass index and better integration in social activities correlate positively. The following formula analyses the expectations of better integration in social life: social expectations = 116-0.991 × age.
  
  
  CONCLUSIONS
  For the first time this study determines expectations and influential factors of patients who undergo a total knee replacement in Germany. By knowing the interaction of satisfaction and preoperative expectations, this knowledge is an essential condition to increase satisfaction after total knee replacement in the German population. Collecting the preoperative expectations of patients has to be an indispensable feature of the clinical practice in orthopaedic surgery.
authors.affiliation: Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim.
authors.forename: A
authors.initials: A
authors.lastname: Schulze
authors.affiliation: Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim.
authors.forename: K
authors.initials: K
authors.lastname: Fleskes
authors.affiliation: Orthopädisch-Unfallchirurgisches Zentrum, Universitätsmedizin Mannheim.
authors.forename: H-P
authors.initials: HP
authors.lastname: Scharf
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D017677:Age Distribution; D000368:Aged; D059031:Anticipation, Psychological; D018771:Arthralgia / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology*; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000706:statistics & numerical data*; D001294:Attitude to Health; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D057234:Preoperative Period; D015995:Prevalence; D020127:Recovery of Function; D017678:Sex Distribution; D016896:Treatment Outcome