Research Summary

Patients Reporting Satisfaction After Total Knee Arthroplasty Show Greater Gains in Pain, Function

Miranda Manier, BA

Key Highlights

  • Nearly 90% of patients reported satisfaction after total knee arthroplasty.
  • Greater satisfaction was associated with older age and higher BMI.
  • Satisfied patients showed significantly greater improvements in pain and function scores.
  • Functional outcomes improved across all patients from baseline to 1-year post-operation.

In a modern cohort of patients undergoing total knee arthroplasty (TKA), nearly 90% reported being satisfied with their surgical outcomes—a rate notably higher than the frequently cited benchmark of 80%. Satisfied patients experienced larger improvements in pain and function measures both before and after surgery.

The study was initiated to reassess patient satisfaction rates in the context of evolving perioperative care, implant technology, and surgical techniques. As TKA is increasingly common and central to improving pain and mobility in patients with advanced knee arthritis, updated evaluations of satisfaction can help guide both patient expectations and clinical decision-making.

This retrospective analysis included 1702 patients who underwent unilateral or bilateral TKA between November 2018 and December 2023 and who participated in a web-based home therapy program. Patients were stratified by reported satisfaction with surgical outcomes. Researchers conducted univariate analyses to examine differences in demographics and pre/postoperative scores and used multivariate logistic regression to identify factors independently predictive of satisfaction.

Overall, functional outcomes significantly improved across the entire cohort, with marked increases in Patient-Reported Outcomes Measurement Information System (PROMIS) scores (overall, physical, and mental), Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR), and reductions in visual analog scale (VAS) pain scores from preoperative baseline to 1 year postoperatively (P < .001). Satisfied patients were generally older, had a higher BMI, and were more likely to have hypertension (P = .05 for each). Preoperatively, they also had higher PROMIS overall, PROMIS mental, and KOOS JR scores (P < .05), and at 1 year, demonstrated significantly greater improvement across all patient-reported outcome measures (P < .001). On multivariate analysis, only age and BMI remained significant predictors of postoperative satisfaction, with both showing modest but statistically significant odds ratios.

“In a modern cohort of TKA patients, nearly 90% reported satisfaction following surgery,” researchers concluded. “Satisfied patients had higher preoperative and postoperative functional outcome scores. Older age and BMI were strongly predictive of postoperative satisfaction.”

Reference:
Singh M, Harary J, Schilling PL, Moschetti WE. Patient satisfaction is nearly 90% after total knee arthroplasty; we are better than we were. J Arthroplasty. 2025;40(6):1521-1525.e1. doi:10.1016/j.arth.2024.11.03