Enhanced Treatment Outcomes After Total Knee Arthroplasty Correlate with Patient Satisfaction

Overview

This study of 582 total knee arthroplasty (TKA) patients found that 85.8% were responders with significant symptom improvement, correlating with higher satisfaction scores. Non-responders (14.2%) reported lower satisfaction and were less likely to undergo surgery again. The individual treatment effect (TE) calculated from Oxford Knee Scores strongly predicted patient satisfaction.

Background

Total knee arthroplasty is a common procedure with excellent long-term implant survival, yet dissatisfaction rates range from 14% to 27%. Traditional outcome measures focus on objective parameters, but patient-reported outcome measures (PROMs) reveal that some patients experience no improvement or worsening symptoms. The treatment effect (TE) method allows individual assessment of symptom changes post-TKA. Understanding factors influencing patient satisfaction, including pain relief, function, and expectation fulfillment, is critical for improving outcomes.

Data Highlights

Key Findings

• 85.8% of patients were responders with a TE > 0.2, indicating meaningful symptom improvement after TKA.
• Non-responders (14.2%) showed unchanged or worsened symptoms and reported significantly lower satisfaction scores.
• Higher individual treatment effects correlated strongly with higher patient satisfaction measured on a 0–10 visual analogue scale.
• Responders were more likely to state they would undergo TKA surgery again if needed.
• Patient satisfaction was influenced by individual symptom improvement rather than solely by objective clinical measures.
• The TE method provides a simple, individualized assessment of treatment success correlating with patient satisfaction.

Clinical Implications

Clinicians should incorporate individual patient-reported treatment effects when evaluating TKA outcomes to better identify patients at risk of dissatisfaction. Using TE alongside PROMs can guide postoperative management and patient counseling. Understanding that not all patients improve equally emphasizes the need for personalized approaches to optimize satisfaction and functional recovery.

Conclusion

Individual treatment effect after total knee arthroplasty is a strong predictor of patient satisfaction. Assessing TE can enhance understanding of patient outcomes beyond traditional clinical measures and support improved patient-centered care.

References

1. Registry and PROM studies cited (e.g., refs 5, 6, 8, 14, 16, 23, 26, 28, 30)