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Bone Joint J. 2014 Nov;96-B(11 Supple A):96-100. doi: 10.1302/0301-620X.96B11.34152.

Patient dissatisfaction following total knee replacement: a growing concern?

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Washington University School of Medicine/Barnes-Jewish Hospital, Department of Orthopedic Surgery, 660 S. Euclid Ave., Campus Box 8233, St. Louis, Missouri, USA.


A national, multi-centre study was designed in which a questionnaire quantifying the degree of patient satisfaction and residual symptoms in patients following total knee replacement (TKR) was administered by an independent, blinded third party survey centre. A total of 90% of patients reported satisfaction with the overall functioning of their knee, but 66% felt their knee to be 'normal', with the reported incidence of residual symptoms and functional problems ranging from 33% to 54%. Female patients and patients from low-income households had increased odds of reporting dissatisfaction. Neither the use of contemporary implant designs (gender-specific, high-flex, rotating platform) or custom cutting guides (CCG) with a neutral mechanical axis target improved patient-perceived outcomes. However, use of a CCG to perform a so-called kinematically aligned TKR showed a trend towards more patients reporting their knee to feel 'normal' when compared with a so called mechanically aligned TKR This data shows a degree of dissatisfaction and residual symptoms following TKR, and that several recent modifications in implant design and surgical technique have not improved the current situation.


Outcomes; Knee replacement; Patient satisfaction; Total knee arthroplasty

[Indexed for MEDLINE]

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