Abstract
Background
Patient satisfaction has become an important parameter for assessing overall outcomes after total knee arthroplasty (TKA). The level of difficulty in performing activities of daily life that affects overall patient satisfaction is unknown. We therefore evaluated the influence of difficulty in performing activities of daily life on patient satisfaction and expectations.
Methods
The 2011 Knee Society Knee Scoring System Questionnaire was mailed to patients who had undergone TKA with 375 patients completing and returning it. We evaluated the relationship between the ability to perform daily activities, as assessed via the questionnaire, and patient satisfaction and expectations of the same score in each patient using linear regression analysis. We also determined which activities affected patient satisfaction and expectations using multivariate linear regression analyses.
Results
All patient-derived functional activities correlated significantly with the patient satisfaction score. In particular, “climbing up or down a flight of stairs” followed by “getting into or out of a car,” “moving laterally (stepping to the side)” and “walking and standing” correlated strongly with patient satisfaction by linear regression analysis and were revealed to have significant contributions to patient satisfaction by multivariate linear regression analysis. Regarding expectations, all patient-derived functional activities correlated significantly with the patient expectation score, although none of the correlation coefficients was very high. “Squatting,” followed by “walking and standing,” contributed to the patient expectation score by multivariate linear regression analysis.
Conclusion
Activities related to walking and standing are some of the most basic movements and basic demands for patients. In addition, “climbing up or down a flight of stairs,” “getting into and out of a car” and “squatting” are very important and distressing activities that significantly correlate with patient satisfaction after TKA.
Similar content being viewed by others
References
Anderson JG, Wixson RL, Tsai D, Stulberg SD, Chang RW. Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplast. 1996;11:831–40.
Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res. 2006;452:35–43.
Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000;71:262–7.
Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R, Katz B, Bombardier C, Heck D, Freund D. Health-related quality of life after knee replacement. J Bone Joint Surg Am. 1998;80:163–73.
Heck DA, Robinson RL, Partridge CM, Lubitz RM, Freund DA. Patient outcomes after knee replacement. Clin Orthop Relat Res. 1998;356:93–110.
Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468:57–63.
Baumann C, Rat AC, Mainard D, Cuny C, Guillemin F. Importance of patient satisfaction with care in predicting osteoarthritis specific health-related quality of life one year after total joint arthroplasty. Qual Life Res. 2011;20:1581–8.
Becker R, Doring C, Denecke A, Brosz M. Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011;19:1433–41.
Kwon SK, Kang YG, Kim SJ, Chang CB, Seong SC, Kim TK. Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty. J Arthroplast. 2010;25:1125–30.
Gandhi R, Davey JR, Mahomed NN. Predicting patient dissatisfaction following joint replacement surgery. J Rheumatol. 2008;35:2415–8.
Baker PN, van der Meulen JH, Lewsey J, Gregg PJ. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg Br. 2007;89:893–900.
Noble PC, Scuderi GR, Brekke AC, Sikorskii A, Benjamin JB, Lonner JH, Chadha P, Daylamani DA, Scott WN, Bourne RB. Development of a new Knee Society scoring system. Clin Orthop Relat Res. 2012;470:20–32.
Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new Knee Society knee scoring system. Clin Orthop Relat Res. 2012;470:3–19.
Matsuda S, Kawahara S, Okazaki K, Tashiro Y, Iwamoto Y. Postoperative alignment and ROM affect patient satisfaction after TKA. Clin Orthop Relat Res. 2013;471:127–33.
Lopez-Olivo MA, Landon GC, Siff SJ, Edelstein D, Pak C, Kallen MA, Stanley M, Zhang H, Robinson KC, Suarez-Almazor ME. Psychosocial determinants of outcomes in knee replacement. Ann Rheum Dis. 2011;70:1775–81.
Scott CE, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br. 2010;92:1253–8.
Vissers MM, de Groot IB, Reijman M, Bussmann JB, Stam HJ, Verhaar JA. Functional capacity and actual daily activity do not contribute to patient satisfaction after total knee arthroplasty. BMC Musculoskelet Disord. 2010;11:121.
Wright JG, Santaguida PL, Young N, Hawker GA, Schemitsch E, Owen JL. Patient preferences before and after total knee arthroplasty. J Clin Epidemiol. 2010;63:774–82.
Nilsdotter AK, Toksvig-Larsen S, Roos EM. Knee arthroplasty: are patients’ expectations fulfilled?: a prospective study of pain and function in 102 patients with 5-year follow up. Acta Orthop. 2009;80:55–61.
Mahomed NN, Liang MH, Cook EF, Daltroy LH, Fortin PR, Fossel AH, Katz JN. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol. 2002;29:1273–9.
Mancuso CA, Jout J, Salvati EA, Sculco TP. Fulfillment of patients’ expectations for total hip arthroplasty. J Bone Joint Surg Am. 2009;91:2073–8.
Acknowledgments
This work was partially supported by a Grant-in-Aid for Specially Promoted Research (Grant Number 23000011) from the Japan Society for the Promotion of Science.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Nakahara, H., Okazaki, K., Mizu-uchi, H. et al. Correlations between patient satisfaction and ability to perform daily activities after total knee arthroplasty: why aren’t patients satisfied?. J Orthop Sci 20, 87–92 (2015). https://doi.org/10.1007/s00776-014-0671-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00776-014-0671-7