Deakin AH, Smith MA, Wallace DT, Smith EJ, Sarungi M. Fulfilment of preoperative expectations and postoperative patient satisfaction after total knee replacement. A prospective analysis of 200 patients.
Knee 2019;
26:1403-1412. [PMID:
31474421 DOI:
10.1016/j.knee.2019.07.018]
[Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 03/04/2019] [Accepted: 07/31/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND
In total knee arthroplasty (TKA), the association between preoperative patient expectations, their postoperative fulfilment, and satisfaction is not well understood. The aim of this study was to quantify these relationships in a cohort of TKA patients with differing socio-economic backgrounds from across Scotland.
METHODS
Expectations of 200 patients undergoing TKA were assessed using the Hospital for Special Surgery Knee Replacement Expectation Score. Postoperatively, expectation fulfilment was assessed at six weeks and one year. Satisfaction was measured using a five-point Likert scale. Preoperative and postoperative scores were compared across satisfaction groups. Relationships between individual and overall expectation fulfilment, satisfaction, and demographics were analysed.
RESULTS
At six weeks, 30% of expectations were fulfilled, increasing to 48% at one year. Corresponding satisfaction rates were 84% and 89%. Higher fulfilment scores were associated with greater satisfaction. Fulfilment of pain and mobility expectations were most predictive of satisfaction. Expectations of kneeling, squatting, paid work and sexual function went unfulfilled. Preoperative expectations were not related to postoperative satisfaction. Males had higher postoperative fulfilment scores.
CONCLUSIONS
This study showed a clear association between fulfilment of preoperative expectations and patient satisfaction following TKA. However, less than 50% of patient expectations were completely fulfilled. While higher fulfilment scores were predictive of greater satisfaction, low overall fulfilment score did not preclude satisfaction. The high correlation of pain and function expectation fulfilment with satisfaction emphasises the need to relate these as appropriate preoperative expectations, while awareness of unfulfilled expectations may allow engagement with and resolution of ongoing concerns and disappointments.
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