Download PDF
J Knee Surg 2020; 33(10): 1034-1040
DOI: 10.1055/s-0039-1692632
Original Article

Outcome Expectations of Total Knee Arthroplasty Patients: The Influence of Demographic Factors, Pain, Personality Traits, Physical and Psychological Status

Jaap J. Tolk
1   Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Eindhoven, the Netherlands
,
Rob P. A. Janssen
1   Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Eindhoven, the Netherlands
,
Tsjitske M. Haanstra
2   Department of Orthopedic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
,
Marieke M C. van der Steen
1   Department of Orthopedic Surgery and Trauma, Máxima Medical Center, Eindhoven, the Netherlands
3   Department of Orthopedic Surgery, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
,
Sita M. A. Bierma Zeinstra
4   Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
5   Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
,
M. Reijman
5   Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Unfulfilled preoperative expectations have a strong influence on the outcome after total knee arthroplasty (TKA). More insight into determinants of the level of expectations is useful in identifying patients at risk for having expectations of the treatment result that are too high or too low. This information can be used in optimizing preoperative expectation management. The aim of the current study was to analyze to what extent preoperative outcome expectations of TKA patients are affected by psychological factors, demographic factors, pain, physical function, and general health status. We performed a cross-sectional analysis of 204 patients with symptomatic and radiographic knee osteoarthritis (OA), scheduled for primary TKA. Outcome expectations were measured using the hospital for special surgery knee replacement expectations survey. Independent variables included were age, sex, body mass index, and patient-reported outcome measures for pain, physical function, quality of life, anxiety, depression, catastrophizing, optimism, and pessimism. Multiple linear regression analyses were used to evaluate associations between these variables and preoperative outcome expectations. Female sex, higher age, higher depression score, and duration of complaints > 50 months showed to be significant predictors of lower expectations for the treatment outcome after TKA. Baseline pain and function scores were not related to the level of preoperative expectations. The present study aids in identifying patients at risk for having either too high or too low expectations. This knowledge can be utilized in individualized expectation management interventions.

Keywords

total knee arthroplasty - expectations - prediction - expectation management


Publication History

Received: 29 November 2018

Accepted: 05 May 2019

Article published online:
04 July 2019

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

  • References

  • 1 Cross M, Smith E, Hoy D. , et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014; 73 (07) 1323-1330
    Google Scholar
  • 2 Dunbar MJ, Richardson G, Robertsson O. I can't get no satisfaction after my total knee replacement: rhymes and reasons. Bone Joint J 2013; 95-B (11, Suppl. A): 148-152
    CrossrefPubMedGoogle Scholar
  • 3 Gunaratne R, Pratt DN, Banda J, Fick DP, Khan RJK, Robertson BW. Patient dissatisfaction following total knee arthroplasty: a systematic review of the literature. J Arthroplasty 2017; 32 (12) 3854-3860
    Google Scholar
  • 4 Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 2006; 452 (452) 35-43
    CrossrefPubMedGoogle Scholar
  • 5 Mancuso CA, Graziano S, Briskie LM. , et al. Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties. Clin Orthop Relat Res 2008; 466 (02) 424-431
    CrossrefPubMedGoogle Scholar
  • 6 Tolk JJ, van der Steen MC, Janssen RPA, Reijman M. Total knee arthroplasty: what to expect? A survey of the members of the Dutch Knee Society on long-term recovery after total knee arthroplasty. J Knee Surg 2017; 30 (06) 612-616
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Tolk JJ, Janssen RPA, Haanstra TM, Bierma-Zeinstra SMA, Reijman M. The EKSPECT study: the influence of expectation modification in knee arthroplasty on satisfaction of patients: study protocol for a randomized controlled trial. Trials 2018; 19 (01) 437
    CrossrefPubMedGoogle Scholar
  • 8 Jain D, Nguyen LL, Bendich I. , et al. Higher patient expectations predict higher patient-reported outcomes, but not satisfaction, in total knee arthroplasty patients: a prospective multicenter study. J Arthroplasty 2017; 32 (9S): S166-S170
    CrossrefPubMedGoogle Scholar
  • 9 Hepinstall MS, Rutledge JR, Bornstein LJ, Mazumdar M, Westrich GH. Factors that impact expectations before total knee arthroplasty. J Arthroplasty 2011; 26 (06) 870-876
    CrossrefPubMedGoogle Scholar
  • 10 J Smith E, Soon V-L, Boyd A, McAllister J, Deakin AH, Sarungi M. What do Scottish patients expect of their total knee arthroplasty?. J Arthroplasty 2016; 31 (04) 786-792
    CrossrefPubMedGoogle Scholar
  • 11 Bjorgul K, Novicoff WM, Saleh KJ. Evaluating comorbidities in total hip and knee arthroplasty: available instruments. J Orthop Traumatol 2010; 11 (04) 203-209
    CrossrefPubMedGoogle Scholar
  • 12 Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16 (04) 494-502
    Google Scholar
  • 13 van den Akker-Scheek I, van Raay JJ, Reininga IH, Bulstra SK, Zijlstra W, Stevens M. Reliability and concurrent validity of the Dutch hip and knee replacement expectations surveys. BMC Musculoskelet Disord 2010; 11 (01) 242
    CrossrefPubMedGoogle Scholar
  • 14 Mancuso CA, Sculco TP, Wickiewicz TL. , et al. Patients' expectations of knee surgery. J Bone Joint Surg Am 2001; 83-A (07) 1005-1012
    CrossrefPubMedGoogle Scholar
  • 15 Zywiel MG, Mahomed A, Gandhi R, Perruccio AV, Mahomed NN. Measuring expectations in orthopaedic surgery: a systematic review. Clin Orthop Relat Res 2013; 471 (11) 3446-3456
    CrossrefPubMedGoogle Scholar
  • 16 de Groot IB, Favejee MM, Reijman M, Verhaar JA, Terwee CB. The Dutch version of the Knee Injury and Osteoarthritis Outcome Score: a validation study. Health Qual Life Outcomes 2008; 6: 16
    CrossrefPubMedGoogle Scholar
  • 17 Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Outcome. Arthritis Care Res (Hoboken) 2011; 63 (Suppl. 01) S208-S228 . Doi: 10.1002/acr.20632
    Google Scholar
  • 18 Haverkamp D, Breugem SJM, Sierevelt IN, Blankevoort L, van Dijk CN. Translation and validation of the Dutch version of the Oxford 12-item knee questionnaire for knee arthroplasty. Acta Orthop 2005; 76 (03) 347-352
    CrossrefPubMedGoogle Scholar
  • 19 Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001; 33 (05) 337-343
    CrossrefPubMedGoogle Scholar
  • 20 Conner-Spady BL, Marshall DA, Bohm E. , et al. Reliability and validity of the EQ-5D-5L compared to the EQ-5D-3L in patients with osteoarthritis referred for hip and knee replacement. Qual Life Res 2015; 24 (07) 1775-1784
    CrossrefPubMedGoogle Scholar
  • 21 Ruyssen-Witrand A, Fernandez-Lopez CJ, Gossec L, Anract P, Courpied JP, Dougados M. Psychometric properties of the OARSI/OMERACT osteoarthritis pain and functional impairment scales: ICOAP, KOOS-PS and HOOS-PS. Clin Exp Rheumatol 2011; 29 (02) 231-237
    PubMedGoogle Scholar
  • 22 Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res 2002; 52 (02) 69-77
    Google Scholar
  • 23 Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 1997; 27 (02) 363-370
    CrossrefPubMedGoogle Scholar
  • 24 Van Damme S, Crombez G, Vlaeyen J, Goubert L, Van den Broeck A, Van Houdenhove B. De Pain Catastrophizing Scale: psychometrische karakteristieken en normering. 2000;3:211–222. Gedragstherapie 2000; 3: 211-222
    PubMedGoogle Scholar
  • 25 Sullivan MJL, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995; 7 (04) 524-532
    Google Scholar
  • 26 ten Klooster PM, Weekers AM, Eggelmeijer F. , et al. Optimisme en / of pessimisme: factorstructuur van de Nederlandse Life Orientation Test Revised. Psychol Gezondheid 2010; 38 (02) 89-100
    CrossrefPubMedGoogle Scholar
  • 27 Jakobsen JC, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials - a practical guide with flowcharts. BMC Med Res Methodol 2017; 17 (01) 162
    CrossrefPubMedGoogle Scholar
  • 28 Razmjou H, Finkelstein JA, Yee A, Holtby R, Vidmar M, Ford M. Relationship between preoperative patient characteristics and expectations in candidates for total knee arthroplasty. Physiother Can 2009; 61 (01) 38-45
    CrossrefPubMedGoogle Scholar
  • 29 Tolk JJ, Haanstra TM, Reijman M. Letter to the editor on “What do Scottish Patients Expect of Their Total Knee Arthroplasty?”. J Arthroplasty 2016; 31 (10) 2374
    CrossrefPubMedGoogle Scholar
  • 30 Riddle DL, Golladay GJ, Hayes A, Ghomrawi HMK. Poor expectations of knee replacement benefit are associated with modifiable psychological factors and influence the decision to have surgery: A cross-sectional and longitudinal study of a community-based sample. Knee 2017; 24 (02) 354-361
    CrossrefPubMedGoogle Scholar
  • 31 Mahomed NN, Liang MH, Cook EF. , et al. The importance of patient expectations in predicting functional outcomes after total joint arthroplasty. J Rheumatol 2002; 29 (06) 1273-1279
    PubMedGoogle Scholar
  • 32 Lingard EA, Sledge CB, Learmonth ID. ; Kinemax Outcomes Group. Patient expectations regarding total knee arthroplasty: differences among the United States, United kingdom, and Australia. J Bone Jt Surg, Am 2006; 88 (06) 1201-1207
    PubMedGoogle Scholar
  • 33 Hanusch BC, O'Connor DB, Ions P, Scott A, Gregg PJ. Effects of psychological distress and perceptions of illness on recovery from total knee replacement. Bone Joint J 2014; 96-B (02) 210-216
    CrossrefPubMedGoogle Scholar
  • 34 Vissers MM, Bussmann JB, Verhaar JAN, Busschbach JJV, Bierma-Zeinstra SMA, Reijman M. Psychological factors affecting the outcome of total hip and knee arthroplasty: a systematic review. Semin Arthritis Rheum 2012; 41 (04) 576-588
    Google Scholar
  • 35 Flood AB, Lorence DP, Ding J, McPherson K, Black NA. The role of expectations in patients' reports of post-operative outcomes and improvement following therapy. Med Care 1993; 31 (11) 1043-1056
    CrossrefPubMedGoogle Scholar
  • 36 Colloca L, Miller FG. Harnessing the placebo effect: the need for translational research. Philos Trans R Soc Lond B Biol Sci 2011; 366 (1,572): 1922-1930
    CrossrefPubMedGoogle Scholar
  • 37 Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand 2000; 71 (03) 262-267
    CrossrefPubMedGoogle Scholar
  • 38 Berliner JL, Brodke DJ, Chan V, SooHoo NF, Bozic KJ. Can preoperative patient-reported outcome measures be used to predict meaningful improvement in function after TKA?. Clin Orthop Relat Res 2016; 475 (01) 149-157
    CrossrefPubMedGoogle Scholar
  • 39 Dutch Arthroplasty Register (LROI). Online LROI Annual Report 2018. Accessed May 29, 2019 at: http://www.lroi-rapportage.nl/media/pdf/PDF%20Online_LROI_annual_report_2018.pdf
    Google Scholar