Patient Satisfaction Is Nearly 90% After Total Knee Arthroplasty; We Are Better Than We Were

Total knee arthroplasty (TKA) is frequently performed to reduce pain and improve quality of life. Patient satisfaction following TKA is commonly reported at 80%. However, given recent advancements in perioperative management, implants, and operative techniques, new assessments on patient satisfaction are warranted.

Patients who underwent unilateral or bilateral TKA between November 2018 and December 2023 and used a web-based home therapy program were included. In total, 1,702 patients with 1,527 (89.7%) reporting satisfaction following TKA were included. Patients were stratified by satisfaction with postoperative outcomes. Univariate analyses were performed on demographics and patient-reported outcomes. Multivariate logistic regression analyses were performed to identify parameters predictive of postoperative satisfaction with TKA.

Satisfied patients had higher mean age, body mass index (BMI), and hypertension (all P = 0.05). Throughout the entire cohort, Patient-Reported Outcomes Measurement Information System (PROMIS), Knee Injury and Osteoarthritis Outcome Score Junior (KOOS Jr), and visual analog scale pain scores improved from preoperatively to 1 year postoperatively (P < 0.001). Preoperatively, satisfied patients reported higher PROMIS overall, PROMIS mental, and KOOS Jr scores (all P < 0.05). At one year postoperatively, satisfied patients noted larger improvements in all functional outcomes, thus resulting in better PROMIS overall, PROMIS physical, PROMIS mental, KOOS Jr, and visual analog scale pain scores (all P < 0.001). Multivariate logistic regression analyses revealed that only age (odds ratio = 1.0, P = 0.005) and BMI (odds ratio = 1.0, P = 0.006) were predictive of satisfaction after TKA procedure.

In a modern cohort of TKA patients, nearly 90% reported satisfaction following surgery. Satisfied patients had higher preoperative and postoperative functional outcome scores. Older age and BMI were strongly predictive of postoperative satisfaction. Although careful preoperative selection of patients should still be employed, patient satisfaction following TKA may be higher than commonly reported.