Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 27;16(8):e67942.
doi: 10.7759/cureus.67942. eCollection 2024 Aug.

Awareness and Underlying Factors for Total Knee Arthroplasty Reluctance in Saudi Arabia

Talal A Alkindy  1 , Amirah Abdullah A Alatawi  2 , Meshari Salman A Alhawiti  2 , Osama Nasser A Alayda  2 , Randa Abdullah E Altuwaijri  3 , Abdulrahman Abdullah S Alelyani  2 , Abdullah Nasser A Alayda  2 , Abdulrahman Mushabab A Almurayeh  4
Affiliations

Awareness and Underlying Factors for Total Knee Arthroplasty Reluctance in Saudi Arabia

Talal A Alkindy et al. Cureus. .

Abstract

Background Total knee arthroplasty (TKA) is a successful surgical intervention for advanced knee arthritis. The efficacy of TKA in reducing pain and restoring joint function has been well documented. Despite the rewarding outcomes of TKA for knee osteoarthritis patients, their willingness to consider the procedure is limited. Aim This study aimed to assess patients' awareness and knowledge of total knee arthroplasty benefits and complications. Further, the reasons and factors contributing to reluctance among orthopedic patients in Saudi Arabia should be determined. Methods An online, structured, and self-administered questionnaire was used to collect data from adult orthopedic patients of both genders who were reluctant to undergo total knee arthroplasty despite surgeons' recommendations. The online questionnaire link was shared across multiple platforms, orthopedic forums, and healthcare social media channels. Qualitative data were presented as frequencies and percentages, while continuous data were reported as the mean (standard deviation [SD]). The statistical package for the social sciences software program was used for statistical analysis. Results A total of 629 participants were involved. The awareness of the expected benefits score, on a scale from 7 to 35, showed a mean (SD) of 20.9 (5.6). The score of the attitude towards expected complications, on a scale from 5 to 25, had a mean (SD) of 15.2 (3.6). The attitude towards the expected complications showed a significantly higher mean (SD) score in the older group aged >60 years than the younger one aged <40 years (15.7 (4.1) vs. 14.9 (3.5), respectively). Likewise, overweight and obese participants showed a significantly higher mean (SD) expected complications score compared to the healthy and underweight ones (15.4 (3.7) vs. 14.8 (3.5), respectively). The recorded reasons for refusal to undergo TKA were fear of anesthesia complications (317, 50.4%), followed by financial limitations (245, 39.0%), the unavailability of experienced surgeons (232, 36.9%), and fear of unfavorable outcomes (189, 30.0%). Conclusion There was a gap in knowledge and awareness of total knee arthroplasty among orthopedic patients in Saudi Arabia. Perceptions of benefits were inadequate, and there were misconceptions about the expected complications. The level of expected complications was higher among elderly and obese patients. Furthermore, fear of anesthesia complications and unfavorable outcomes, in addition to economic and financial problems, constituted major barriers to undergoing the procedure.

Keywords: awareness; expectation; knowledge; reluctance; total knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of The University of Tabuk issued approval UT-384-227-2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Correlation between health status and expected benefits scores.
Figure 2
Figure 2. Correlation between health status and expected complications scores.
Figure 3
Figure 3. Reasons for refusal to undergo total knee arthroplasty.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Predicting the outcome of total knee arthroplasty using the WOMAC score: a review of the literature. Walker LC, Clement ND, Deehan DJ. J Knee Surg. 2019;32:736–741. - PubMed
    1. Unlocking the secrets of post-surgical flexion: the vital role of rehabilitation in total knee arthroplasty recovery. Murvai GF, Hozan CT, Ghitea TC, Cavalu S. Prosthesis. 2023;5:1357–1368.
    1. Total knee replacement at Southwestern Saudi Arabia: a single-center experience. Al-Otaibi ML. J Family Med Prim Care. 2021;10:2166–2170. - PMC - PubMed
    1. Update on unicompartmental knee arthroplasty: current indications and failure modes. Vasso M, Antoniadis A, Helmy N. EFORT Open Rev. 2018;3:442–448. - PMC - PubMed
    1. Predictors of a change in patient willingness to have Total knee arthroplasty: Insights from the osteoarthritis initiative. Bendich I, Halvorson RT, Ward D, Nevitt M. Knee. 2020;27:667–675. - PubMed

LinkOut - more resources