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The rate and predictors of patient satisfaction after total knee arthroplasty are influenced by the focus of the question: A standard satisfaction question is required

Lookup NU author(s): Michelle Bardgett, Dr Jennifer Holland, Craig Gerrand, Professor David Deehan


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© 2018 The British Editorial Society of Bone & Joint Surgery. Aims The primary aim of this study was to assess the rate of patient satisfaction one year after total knee arthroplasty (TKA) according to the focus of the question asked. The secondary aims were to identify independent predictors of patient satisfaction according to the focus of the question. Patients and Methods A retrospective cohort of 2521 patients undergoing a primary unilateral TKA were identified from an established regional arthroplasty database. Patient demographics, comorbidities, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 12-Item Short-Form Health Survey (SF-12) scores were collected preoperatively and one year postoperatively. Patient satisfaction was assessed using four questions, which focused on overall outcome, activity, work, and pain. Logistic regression analysis was used to identify independent preoperative predictors of increased stiffness when adjusting for confounding variables. Results Using patient satisfaction with the overall outcome (n = 2265, 89.8%) as the standard, there was no difference in the rate of satisfaction for pain relief (n = 2277, odds ratio (OR) 0.95, 95% confident intervals (CI) 0.79 to 1.14, p = 0.60), but patients were more likely to be dissatisfied with activities (79.3%, n = 2000/2521, OR 2.22, 95% CI 1.96 to 2.70, p < 0.001) and work (85.8%, n = 2163/2521, OR 1.47, 95% CI 1.23 to 1.75, p < 0.001). Logistic regression analysis identified different predictors of satisfaction for each of the focused satisfaction questions. Overall satisfaction was influenced by diabetes (p = 0.03), depression (p = 0.004), back pain (p < 0.001), and SF-12 physical (p = 0.008) and mental (p = 0.01) components. Satisfaction with activities was influenced by depression (p = 0.001), back pain (p < 0.001), WOMAC stiffness score (p = 0.03), and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with work was influenced by depression (p = 0.007), back pain (p < 0.001), WOMAC function (p = 0.04) and stiffness (p = 0.05) scores, and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with pain relief was influenced by diabetes (p < 0.001), back pain (p < 0.001), and SF-12 mental component (p = 0.04). Conclusion The focus of the satisfaction question significantly influences the rate and the predictors of patient satisfaction after TKA.

Publication metadata

Author(s): Clement ND, Bardgett M, Weir D, Holland J, Gerrand C, Deehan DJ

Publication type: Article

Publication status: Published

Journal: Bone and Joint Journal

Year: 2018

Volume: 100B

Issue: 6

Pages: 740-748

Print publication date: 01/06/2018

Online publication date: 01/06/2018

Acceptance date: 02/04/2018

ISSN (print): 2049-4394

ISSN (electronic): 2049-4408

Publisher: British Editorial Society of Bone and Joint Surgery


DOI: 10.1302/0301-620X.100B6.BJJ-2017-1292.R1


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