Abstract
Multiple large studies, including from national registries, have demonstrated that satisfaction rates after total knee arthroplasty are limited to approximately 80%. That is, surprisingly, one in five patients are not satisfied. Furthermore, satisfaction rates have not improved over the last decade.
The strongest correlates to satisfaction are firstly the relief of pain and secondly the improvement in physical function. However, satisfaction may be disparate to other reported subjective outcomes. It is a nebulous outcome metric.
The largest risk for patient dissatisfaction is unmet expectations post total knee arthroplasty.
Keeping the above risks in mind, an effective strategy to improve satisfaction rates likely should concentrate on reducing pain both immediately post-operatively and long term, improving function of the knee, perhaps through a patient specific alignment approach, and most importantly, by understanding and counseling patients regarding expectations pre-operatively.
