Patient Satisfaction After Total Knee Arthroplasty: Who is Satisfied and Who is Not?

Overview

Journal Clin Orthop Relat Res

Publisher Wolters Kluwer

Specialty Orthopedics

Date 2009 Oct 22

PMID 19844772

Citations 880

Authors

Robert B Bourne

Bert M Chesworth

Aileen M Davis

Nizar N Mahomed

Kory D J Charron

Affiliations

Soon will be listed here.

Abstract

Unlabelled: 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).

Level Of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Citing Articles

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References

Mantyselka P, Kumpusalo E, Ahonen R, Takala J . Patients' versus general practitioners' assessments of pain intensity in primary care patients with non-cancer pain. Br J Gen Pract. 2002; 51(473):995-7. PMC: 1314192. View

Chesworth B, Mahomed N, Bourne R, Davis A . Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery. J Clin Epidemiol. 2008; 61(9):907-18. DOI: 10.1016/j.jclinepi.2007.10.014. View

Wylde V, Dieppe P, Hewlett S, Learmonth I . Total knee replacement: is it really an effective procedure for all?. Knee. 2007; 14(6):417-23. DOI: 10.1016/j.knee.2007.06.001. View

Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L . Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000; 71(3):262-7. DOI: 10.1080/000164700317411852 . View

Bellamy N, BUCHANAN W, Goldsmith C, Campbell J, Stitt L . Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15(12):1833-40. View

Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R . Health-related quality of life after knee replacement. J Bone Joint Surg Am. 1998; 80(2):163-73. DOI: 10.2106/00004623-199802000-00003. View

Bourne R, Sibbald W, Doig G, Lee L, Adolph S, Robertson D . The Southwestern Ontario Joint Replacement Pilot Project: electronic point-of-care data collection. Southwestern Ontario Study Group. Can J Surg. 2001; 44(3):199-202. PMC: 3699128. View

Noble P, Conditt M, Cook K, Mathis K . The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006; 452:35-43. DOI: 10.1097/01.blo.0000238825.63648.1e. View

Mahomed N, Liang M, Cook E, Daltroy L, Fortin P, Fossel A . The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol. 2002; 29(6):1273-9. View

10.

Jorn L, Johnsson R, Toksvig-Larsen S . Patient satisfaction, function and return to work after knee arthroplasty. Acta Orthop Scand. 1999; 70(4):343-7. DOI: 10.3109/17453679908997822. View

11.

Burnett R, Haydon C, Rorabeck C, Bourne R . Patella resurfacing versus nonresurfacing in total knee arthroplasty: results of a randomized controlled clinical trial at a minimum of 10 years' followup. Clin Orthop Relat Res. 2004; (428):12-25. View

12.

Bourne R, McCalden R, MacDonald S, Mokete L, Guerin J . Influence of patient factors on TKA outcomes at 5 to 11 years followup. Clin Orthop Relat Res. 2007; 464:27-31. DOI: 10.1097/BLO.0b013e318159c5ff. View

13.

Janse A, Gemke R, Uiterwaal C, van der Tweel I, Kimpen J, Sinnema G . Quality of life: patients and doctors don't always agree: a meta-analysis. J Clin Epidemiol. 2004; 57(7):653-61. DOI: 10.1016/j.jclinepi.2003.11.013. View

14.

Swets J . Measuring the accuracy of diagnostic systems. Science. 1988; 240(4857):1285-93. DOI: 10.1126/science.3287615. View

15.

Kane R, Saleh K, Wilt T, Bershadsky B, Cross 3rd W, Macdonald R . Total knee replacement. Evid Rep Technol Assess (Summ). 2004; (86):1-8. PMC: 4781011. View

16.

Dunbar M, Robertsson O, Ryd L, Lidgren L . Appropriate questionnaires for knee arthroplasty. Results of a survey of 3600 patients from The Swedish Knee Arthroplasty Registry. J Bone Joint Surg Br. 2001; 83(3):339-44. DOI: 10.1302/0301-620x.83b3.11134. View

17.

Anderson J, Wixson R, Tsai D, Stulberg S, Chang R . Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty. 1996; 11(7):831-40. DOI: 10.1016/s0883-5403(96)80183-5. View

18.

Wylde V, Learmonth I, Potter A, Bettinson K, Lingard E . Patient-reported outcomes after fixed- versus mobile-bearing total knee replacement: a multi-centre randomised controlled trial using the Kinemax total knee replacement. J Bone Joint Surg Br. 2008; 90(9):1172-9. DOI: 10.1302/0301-620X.90B9.21031. View

19.

Katz J, Phillips C, Baron J, Fossel A, Mahomed N, Barrett J . Association of hospital and surgeon volume of total hip replacement with functional status and satisfaction three years following surgery. Arthritis Rheum. 2003; 48(2):560-8. DOI: 10.1002/art.10754. View

20.

Heck D, Robinson R, Partridge C, Lubitz R, Freund D . Patient outcomes after knee replacement. Clin Orthop Relat Res. 1999; (356):93-110. DOI: 10.1097/00003086-199811000-00015. View