Expectations of Singaporean patients concerning activities after total knee arthroplasty

Abstract

Background: There are many factors that affect the experience and satisfaction of a patient undergoing knee replacement surgery. Objective: This study aims to explore the effects of demographic factors, disease severity and several novel parameters on patients’ expectations in a Singaporean population. Methods: Phone interviews were conducted with 69 patients to measure their expectations before total knee arthroplasty (TKA). Information such as demographics, surgical histories, baseline Medical Outcomes Study Short Form 36 (SF-36) score, Knee injury and Osteoarthritis Outcome Score (KOOS), Lower Extremity Activity Scale (LEAS), kneeling ability, quality of reviews from relatives or friends and histories of any traditional therapies utilised were obtained. Radiological severity of osteoarthritis was graded using the Kellgren–Lawrence scale; discordance with severity of knee pain was recorded. Results: Patients expected TKA to result in pain relief, improved mobility, increased ability to participate in physical activities, and paid employment. On multivariate regression analysis, LEAS, SF-36 physical, KOOS-pain and KOOS-activity of daily living scores remained significant predictors of expectations. Conclusion: The results indicated multiple factors influence patient’s expectations pre-operatively and their satisfaction post-operatively. Better patient outcomes may be achieved by making improvements in understanding and moderating patient expectations. Level of evidence: Diagnostic III