Higher Patient Expectations Predict Higher Patient-Reported Outcomes, But Not Satisfaction, in Total Knee
Deeptee Jain1, Long-Co L Nguyen1, Ilya Bendich1
1Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
The Journal of Arthroplasty
|March 5, 2017
Summary
Setting realistic expectations before total knee arthroplasty (TKA) is crucial. Higher patient expectations correlate with better outcomes and satisfaction after TKA surgery.
Area of Science:
- Orthopedic Surgery
- Patient-Reported Outcomes
- Health Services Research
Background:
- The interplay between patient expectations, patient-reported outcomes (PROs), and satisfaction following total knee arthroplasty (TKA) remains unclear.
- Understanding these relationships is vital for improving patient care and surgical success in TKA.
Purpose of the Study:
- To investigate the association between preoperative patient expectations and postoperative outcomes, including PROs and satisfaction, in TKA patients.
- To determine if patient demographics or preoperative function influence preoperative expectations.
Main Methods:
- A prospective study involving primary TKA patients across four institutions.
- Patients completed validated surveys preoperatively (HSS-KRES, SF-12, UCLA activity, KOOS) and postoperatively (HSS-KRFES, satisfaction, PROs) at 6 months and 1 year.
- Step-wise multivariate regression models were utilized to analyze the data.
Main Results:
- Eighty-three patients were enrolled with high follow-up rates (84.3% at 6 months, 92.7% at 1 year).
- Preoperative expectations (HSS-KRES) did not predict postoperative satisfaction but were linked to higher fulfillment of expectations (HSS-KRFES) at 1 year.
- Higher preoperative expectations predicted greater improvements in UCLA activity, SF-12 Physical Composite Scale, and KOOS at 6 months and 1 year.
Conclusions:
- Preoperative expectations in TKA patients are independent of demographics and preoperative function.
- Elevated preoperative expectations are associated with enhanced postoperative PROs and greater fulfillment of expectations.
- Emphasizing preoperative patient expectations is essential for optimizing TKA outcomes.
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