Elsevier

The Journal of Arthroplasty

Volume 26, Issue 6, September 2011, Pages 870-876
The Journal of Arthroplasty

Factors That Impact Expectations Before Total Knee Arthroplasty

https://doi.org/10.1016/j.arth.2010.09.010Get rights and content

Abstract

This study examined the effect of patient attributes on expectations before total knee arthroplasty (TKA). A total of 1943 patients completed an Expectations Survey before TKA. Demographics, surgical history, baseline Medical Outcomes Study Short Form 36 (SF-36) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Lower Extremity Activity Scale score were obtained. On univariate analysis, expectations (mean score, 77.6) correlated with SF-36 General Health, age, SF-36 Vitality, KOOS Quality-of-Life, and Lower Extremity Activity Scale. Living alone and history of joint arthroplasty were associated with significantly lower expectations, whereas male sex and white race were associated with higher expectations. On multivariate regression analysis, age, living situation, history of joint arthroplasty, SF-36 General Health, and KOOS Quality-of-Life remained significant predictors of expectations. Our results suggest that high, possibly unrealistic, expectations of TKA are common and should be moderated to maintain patient satisfaction.

Section snippets

Materials and Methods

Since April of 2007, patients scheduled to undergo TKA at our hospital have been recruited to participate in a prospective institutional registry. All patients scheduled for TKA are considered for enrollment. Registry exclusion criteria include patient refusal or inability to complete study instruments and/or the inability of our research staff to encounter the patient before surgery. The battery of study instruments collected preoperatively was modified in early April of 2008. By May 2008, all

Results

During the study period, 3035 patients underwent primary TKA at our institution. Of these, 2925 were successfully encountered before surgery by our research team; and 2382 consented to enroll in the registry. Baseline questionnaires were actually completed by 1943 patients. These 1943 patients constituted our study population. The average age of these patients was 67 (SD 10) years. Baseline general health status as measured by the SF-36, disease severity as measured by the KOOS, and activity as

Discussion

Although knee arthroplasty is an overwhelmingly successful operation, consistently achieving patient satisfaction may be dependent on managing expectations. Previous literature is conflicting and incomplete with regard to the effects of patient factors on expectations. This study sought to describe patient expectations of TKA surgery and to measure the influence of demographics, general health status, and disease severity on those expectations.

The greatest strengths of our study are the large

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Benefits or funds were received in partial or total support of the research material described in this article. These benefits or support were received from the following sources: “Centers for Education & Research on Therapeutics” grant (AHRQ RFA-HS-05-14); Marmor Endowment Committee.

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