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

TLDR

Despite advances in primary TKA, historic implant studies report only 82–89% patient satisfaction. This study reexamined satisfaction rates with contemporary TKA implants. We conducted a cross‑sectional analysis of 1,703 primary TKAs performed in Ontario. Approximately 19% of patients were dissatisfied; pain‑relief satisfaction ranged 72–86% and functional satisfaction 70–84%, with unmet expectations, low 1‑year WOMAC, pre‑operative rest pain, and readmission‑requiring complications being the strongest predictors of dissatisfaction.

Abstract

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).