Bourne and colleagues tested whether contemporary TKA implants had raised patient satisfaction and looked for what set dissatisfied patients apart.
Cross‑sectional survey of 1703 primary TKAs in Ontario, with satisfaction questionnaires mailed 1 year after surgery.
Methods
Design
Cross‑sectional satisfaction survey within a prospective registry cohort
Data source
Ontario Joint Replacement Registry
Surgery June 2001 to December 2005
Patients
1703 primary TKAs
Mean age 69
60% female
92% osteoarthritis
Exposure
Preoperative patient factors
Surgical factors
Postoperative factors
Follow-up
1 year
83% questionnaire response
Outcomes
Overall satisfaction (satisfied vs dissatisfied or neutral)
WOMAC
Key Findings
At 1 year, 19% of patients (328) were dissatisfied or neutral about the overall result.
Satisfaction with pain relief was lowest on stairs (72%), vs 85% walking on level ground.
Satisfaction with function was lowest for getting in or out of a car or bus (70%).
Satisfaction did not differ by cruciate‑retaining vs cruciate‑sacrificing design or by patellar resurfacing.
Of dissatisfied patients, 19.6% would not have the operation again, vs 1.3% of satisfied patients.
Board pearl
Unmet expectations were the strongest predictor of dissatisfaction after TKA, outweighing a poor 1‑year WOMAC, pain at rest before surgery and a postoperative complication.
Authors' conclusion
Our data confirmed that approximately one in five (19%) primary TKA patients were not satisfied with the outcome.
Bourne and colleagues tested whether contemporary TKA implants had raised patient satisfaction and looked for what set dissatisfied patients apart.
Cross‑sectional survey of 1703 primary TKAs in Ontario, with satisfaction questionnaires mailed 1 year after surgery.
Methods
Design
Cross‑sectional satisfaction survey within a prospective registry cohort
Data source
Ontario Joint Replacement Registry
Surgery June 2001 to December 2005
Patients
1703 primary TKAs
Mean age 69
60% female
92% osteoarthritis
Exposure
Preoperative patient factors
Surgical factors
Postoperative factors
Follow-up
1 year
83% questionnaire response
Outcomes
Overall satisfaction (satisfied vs dissatisfied or neutral)
WOMAC
Key Findings
At 1 year, 19% of patients (328) were dissatisfied or neutral about the overall result.
Satisfaction with pain relief was lowest on stairs (72%), vs 85% walking on level ground.
Satisfaction with function was lowest for getting in or out of a car or bus (70%).
Satisfaction did not differ by cruciate‑retaining vs cruciate‑sacrificing design or by patellar resurfacing.
Of dissatisfied patients, 19.6% would not have the operation again, vs 1.3% of satisfied patients.
Board pearl
Unmet expectations were the strongest predictor of dissatisfaction after TKA, outweighing a poor 1‑year WOMAC, pain at rest before surgery and a postoperative complication.
Authors' conclusion
Our data confirmed that approximately one in five (19%) primary TKA patients were not satisfied with the outcome.