Patient Satisfaction Following Primary Total Knee Arthroplasty: Contributing Factors

The reported dissatisfaction rate after primary total knee arthroplasty (TKA) ranges between 15% and 25%. The purposeof this article is to perform a narrative review of the literature with the aim of answering the following question: What arethe main factors contributing to patient dissatisfaction after TKA? A review of the literature was performed on patientsatisfaction after TKA. The search engines used were MedLine (PubMed) and the Cochrane Library. The keywords usedwere “TKA” and “satisfaction”. The main reported preoperative factors positively contributing to patient satisfaction werethe following: fulfilment of preoperative expectations, preoperative complete joint space collapse, increasing patellar andlateral compartment osteophyte size, and TKA communication checklist. The principal preoperative factors negativelycontributing to patient satisfaction included female sex, comorbidities, and Hispanic race. The chief perioperative factorpositively contributing to patient satisfaction was cosmetic closure, whereas the fundamental perioperative factorsnegatively contributing to patient satisfaction included joint laxity, anterior tibial component slope, and greater femoralcomponent valgus angle. The principal postoperative factors positively contributing to patient satisfaction were thefollowing: ameliorated walking distance, improved range of motion, and improvements in pain. The most importantpostoperative factors negatively contributing to patient satisfaction included poor postoperative knee stability and softtissuebalance, functional limitation, surgical complication and reoperation, staff or quality of care issues, and increasedstiffness.Level of evidence: III