title: [Patient expectations and satisfaction concerning total knee arthroplasty].
abstract: BACKGROUND
  Approximately 5-10% of patients is dissatisfied after a total knee arthroplasty. Several studies suggest that unrealistic expectations contribute to this; however, a systematic overview of the literature is missing.
  
  
  METHODS
  Systematic literature review METHOD: Using a systematic search strategy, prospective and retrospective studies with a follow-up of a minimum of six months, were obtained from PubMed publisher, MEDLINE, Embase, Cochrane, PsycINFO, CINAHL, and Web-of-Science. The search terms included 'total knee arthroplasty', 'preoperative expectations' and 'patient satisfaction'. Two reviewers independently selected the studies. Two reviewers independently conducted the quality assessment. Finally, a best evidence synthesis was performed.
  
  
  RESULTS
  The search yielded 6802 studies, of which eight met the inclusion criteria. Limited evidence was found that there is no significant relation between expectations and satisfaction regarding limitations in recreation, walking distance, use of a walking aid and expected time to full recovery. Conflicting evidence was found that high expectations regarding general improvement, pain reduction and limitations in activities of daily living are associated with more dissatisfaction. Moderate evidence was found that patients with unfulfilled expectations were more often dissatisfied.
  
  
  CONCLUSIONS
  Limited prospective research has been published on the relationship between expectations and patient satisfaction concerning total knee arthroplasty. The outcomes are very heterogenous and conclusions from these outcomes should be treated carefully. Future research needs to be more standardised and should utilise validated questionnaires.
authors.affiliation: Erasmus Medisch Centrum, Rotterdam.
authors.forename: T
authors.initials: T
authors.lastname: Duivenvoorden
authors.forename: H
authors.initials: H
authors.lastname: Verburg
authors.forename: J A N
authors.initials: JA
authors.lastname: Verhaar
authors.forename: S M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: M
authors.initials: M
authors.lastname: Reijman
mesh_terms: D000203:Activities of Daily Living; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D017060:Patient Satisfaction; D010549:Personal Satisfaction; D011446:Prospective Studies; D012189:Retrospective Studies