title: Patient satisfaction after total knee arthroplasty: an Asian perspective.
abstract: BACKGROUND
  Total knee arthroplasty (TKA) is an effective method for alleviating pain and restoring knee function in patients with severe osteoarthritis. However, despite the improvements in surgical technique and postoperative care, it has been reported that up to 19% of patients are dissatisfied after their operations. The aim of this study was to evaluate patient satisfaction levels after TKA in an Asian cohort, as well as assess the correlation between patient satisfaction levels and the results of traditional physician-based scoring systems.
  
  
  METHODS
  The medical data of 103 Asian patients who underwent 110 TKAs between December 2008 and June 2009 were obtained from our hospital's Joint Replacement Registry. The minimum follow-up period was one year and patient expectations were assessed before TKA. Patient satisfaction was assessed postoperatively using a 5-point Likert scale. Reasons for patient dissatisfaction were recorded. Standardised instruments (e.g. the Knee Society Score, the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] and the generic Short Form-36 health survey) were used to assess the patient's functional status and the severity of symptoms pre- and postoperatively.
  
  
  RESULTS
  Among the 110 TKAs performed, 92.8% resulted in patient satisfaction. Patient satisfaction correlated with postoperative WOMAC function scores (p = 0.028), postoperative WOMAC final scores (p = 0.040) and expectations being met (p = 0.033).
  
  
  CONCLUSIONS
  Although there was a high level of patient satisfaction following TKA in our cohort of Asian patients, a significant minority was dissatisfied. Patient satisfaction is an important outcome measure and should be assessed in addition to traditional outcome scores.
authors.affiliation: Department of Orthopaedic Surgery, National University Hospital, Singapore.
authors.forename: Matthew Dhanaraj
authors.initials: MD
authors.lastname: Thambiah
authors.affiliation: University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Sahaya
authors.initials: S
authors.lastname: Nathan
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
authors.forename: Branden Z X
authors.initials: BZ
authors.lastname: Seow
authors.affiliation: Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
authors.forename: Shen
authors.initials: S
authors.lastname: Liang
authors.affiliation: University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Krishna
authors.initials: K
authors.lastname: Lingaraj
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology*; D044466:Asian People; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000523:psychology* / Q000601:surgery*; D017060:Patient Satisfaction; D011184:Postoperative Period; D011788:Quality of Life; D016059:Range of Motion, Articular; D012042:Registries; D011795:Surveys and Questionnaires
keywords: Asian; satisfaction; total knee arthroplasty