Key Factors for Achieving Expectations in Patient Satisfaction and Quality of Life After Knee Arthroplasty

In order to determine the most important factors for achieving patient satisfaction and improving quality of life (QOL) following total knee arthroplasty (TKA), validated scales must be used and influences of compounding factors must be accounted for such as comorbidities, mental and emotional problems, and pain in other joints. Although a variety of scales and questions have been used to rate patient satisfaction, few have been validated and there is tremendous variation in recent literature regarding this topic. Conversely, QOL instruments have well-documented psychometric properties and historically have been used throughout the orthopedic literature. Many factors have been shown to be predictive of patient satisfaction, including meeting patient preoperative expectations and postoperative function and pain relief as shown by scores on the Knee Society and Oxford Knee Society scales. Factors predictive of patient dissatisfaction include the presence of two or more comorbidities, female gender, depression, and low preoperative scores on the Medial Outcomes Short Form 12 and Western Ontario and McMaster Universities Osteoarthritis Index instruments.