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The Relationship Between Expectations and Satisfaction in Patients Undergoing Primary Total Knee Arthroplasty

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Abstract

The objective of this literature review was to examine the relationship between expectations and satisfaction in patients undergoing primary total knee arthroplasty (TKA). Five databases were searched from inception to July 2011. Five studies were eligible on the following inclusion criteria: primary TKA, diagnosis of knee osteoarthritis, presurgery outcome measures, a measure of patient expectations and satisfaction, multivariate analysis of the relationship between expectations and satisfaction reported separately for TKA recipients, and English language. Preoperative expectations did not correlate with postoperative satisfaction. However, postoperative satisfaction was predicted by how well postoperative expectations were met after surgery. Therefore, patient education programs for managing expectations should span part of the postoperative recovery period.

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Methods

English-language studies were identified by searching CINAHL, Cochrane library, EMBASE, PubMed, and PsycINFO electronic databases using the following inclusion criteria: primary TKA, diagnosis of knee osteoarthritis (OA), presurgery outcome measures, a measure of patient expectations, a measure of patient satisfaction, and multivariate analysis of the relationship between expectations and satisfaction reported separately for TKA recipients. Additional articles were identified by searching for

Results

Five studies met the inclusion criteria. One study analyzed the relationship between preoperative patient expectations and satisfaction [3]; one study evaluated the relationship between differences in preoperative and postoperative expectations and satisfaction [4]; the third study tested for the separate relationships of preoperative and postoperative expectations with satisfaction [5]; and the other 2 analyzed the relationship between postoperative expectations and satisfaction 6, 7. In each

Discussion

Our hypothesis was that no significant relationship would exist between preoperative expectations and patient satisfaction after primary TKA, when other possible confounders are controlled for in the analysis. Neither of the 2 studies that analyzed the relationship between preoperative patient expectations and postoperative patient satisfaction found a significant association. Mannion et al [4] was the only study that measured a change in expectations but found no relationship between their

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The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.10.005.

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