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Total Knee Arthroplasty: Factors Predicting Patient Satisfaction

Total Knee Arthroplasty: Factors Predicting Patient Satisfaction

Mohamed Amine Gharbi , MD, TUNISIA Mouadh Nefiss, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Anis Tebourbi, MD, TUNISIA

Department of Orthopedics, Mongi Slim University Hospital, La Marsa, Tunis, TUNISIA

2021 Congress   ePoster Presentation     Not yet rated


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Summary: How to ensure patient satisfaction following primary total knee arthroplasty ?


Total knee arthroplasty is one of the most common and rewarding procedures in orthopedic surgery. However, and despite the progress in surgical techniques and the implants development, one in five patients remains dissatisfied with their prosthesis.

The aim of this work was to evaluate the satisfaction rate after total knee arthroplasty and to establish predicting patient satisfaction factors.

Study Design & Methods:
Our study included 170 primary total knee arthroplasties placed between 2015 and 2017 with a minimum follow-up of three years. Our retrospective census took into account the various factors concerning the patient’s background, the surgical procedure and the knee-related parameters before and after surgery. Functional outcomes were assessed using the WOMAC and IKDC subjective scores. Satisfaction was estimated by a yes or no question.


At the last follow-up, all our patients reported a functional improvement with better WOMAC and IKDC scores. The overall dissatisfaction rate was 22.9%. Two parameters concerning the patient's background had a statistically significant link with dissatisfaction: the female sex and the history of diabetes. Only one parameter related to the knee preoperatively had a direct, statistically significant influence on increasing dissatisfaction risk: limited range of motion with flexion <90°. No parameters related to surgery had a statistically significant link with satisfaction. Regarding parameters related to the knee after surgery, only moderate to severe residual pain (VAS>3) was associated with patient dissatisfaction after total knee replacement.


Recognition of factors predicting patient satisfaction after total knee arthroplasty should influence our behavior so as to act on the modifiable factors, allowing to reduce the risk of dissatisfaction to minimum, or to have a more alert attitude towards unmodifiable factors in order to adapt the therapeutic care and to better inform and educate patients.