Only Low Patients' Expectations Are Prognostic for Dissatisfaction With Performing Work-Related Knee-Straining Activities After Total Knee Arthroplasty: A Prospective Multicenter Cohort Study

Yvonne van Zaanen; Tessa Siertsema; Arthur J Kievit; Rutger C I van Geenen; Thijs M J Pahlplatz; Marco J M Hoozemans; Leendert Blankevoort; Matthias U Schafroth; Daniel Haverkamp; Ton M J S Vervest; Dirk H P W Das; Vanessa A Scholtes; P Paul F M Kuijer

doi:10.1016/j.apmr.2023.05.004

Only Low Patients' Expectations Are Prognostic for Dissatisfaction With Performing Work-Related Knee-Straining Activities After Total Knee Arthroplasty: A Prospective Multicenter Cohort Study

Arch Phys Med Rehabil. 2023 Dec;104(12):2051-2058. doi: 10.1016/j.apmr.2023.05.004. Epub 2023 Jun 2.

Affiliations

¹ Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam, Netherlands. Electronic address: y.vanzaanen@amsterdamumc.nl.
² Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam, Netherlands.
³ Amsterdam UMC, University of Amsterdam, Orthopaedic Research Center Amsterdam, Amsterdam, Netherlands.
⁴ Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands.
⁵ Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.
⁶ Xpert Orthopaedics, Amsterdam, Netherlands.
⁷ Department of Orthopaedic Surgery, Tergooi Hospital, Hilversum, Netherlands.
⁸ Department and Research Center of Orthopaedic Surgery, St. Anna Hospital, Geldrop, Netherlands.
⁹ Joint Research Orthopedic Surgery, OLVG+, Amsterdam, Netherlands.

PMID: 37270023
DOI: 10.1016/j.apmr.2023.05.004

Abstract

Objective: To investigate whether preoperative expectations regarding performing work-related knee-straining activities were associated with being dissatisfied 6 months after total knee arthroplasty (TKA) among working patients, and, to identify prognostic factors for being dissatisfied with performing these work-related knee-straining activities.

Design: Multicenter prospective cohort study.

Setting: Orthopedic surgery departments of 7 hospitals in the Netherlands.

Participants: A consecutive sample of 175 working patients who were on the waiting list for TKA (median age 59 years, 53% women) and intended to return to work (N=175).

Interventions: Not applicable.

Main outcome measure(s): Dissatisfaction with performing work-related knee-straining activities 6 months postoperative was measured using the Work Osteoarthritis or joint-Replacement Questionnaire (score range 0-100). The clinically relevant cut-off points for being satisfied and dissatisfied were ≥71 and ≤50, respectively.

Results: Thirty-three patients (19%) were dissatisfied with performing work-related knee-straining activities 6 months after TKA. Patients who expected to be dissatisfied preoperative had a 5.1 times higher odds (95% CI 1.7-15.5) of being dissatisfied 6 months postoperatively compared with patients who expected to be satisfied preoperative. Regression analyses revealed that only patients' expectations were prognostic for being dissatisfied 6 months postoperatively rather than age, pain level, or having a knee-straining job.

Conclusions: Two in 10 working patients are dissatisfied with performing work-related knee-straining activities 6 months after TKA. Only preoperative patients' expectations appeared prognostic. Therefore, we should better prepare working patients with low expectations by managing their preoperative expectations and improving their performance of work-related knee-straining activities in rehabilitation.

Keywords: Arthroplasty; Knee; Motivation; Patient Reported Outcome Measure; Patient satisfaction; Rehabilitation; Replacement.

Publication types

Multicenter Study

MeSH terms

Arthroplasty, Replacement, Knee*
Female
Humans
Male
Middle Aged
Motivation
Osteoarthritis, Knee* / surgery
Patient Satisfaction
Prognosis
Prospective Studies
Treatment Outcome