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Observational Study
. 2025 Jan 24;20(1):e0317205.
doi: 10.1371/journal.pone.0317205. eCollection 2025.

Determining patient activity goals and their fulfillment following total knee arthroplasty: Findings from the prospective, observational SuPeR Knee study

Karen Ribbons  1   2   3 , Kristy Payne  1   2   3 , Elizabeth Ditton  1   2   3 , Sarah Johnson  1   2   4 , Adrian Wills  1   2   4 , Frederick Rohan Walker  1   2   3 , Michael Pollack  1   3   5 , Michael Nilsson  1   2   3   4   5   6
Affiliations
Observational Study

Determining patient activity goals and their fulfillment following total knee arthroplasty: Findings from the prospective, observational SuPeR Knee study

Karen Ribbons et al. PLoS One. .

Abstract

Background: Dissatisfaction with Total Knee Arthroplasty (TKA) surgical outcomes remains between 10-20% and is associated with higher levels of societal costs. Expectations regarding post-surgical outcomes is considered as one of the major factors influencing satisfaction, however, there are no standardised methods for assessing patient's expectations regarding activities to be achieved following surgery.

Objectives: The aims of this study were to identify patient expectations relating to activities of importance following TKA and to describe goal fulfillment at 3 months post-TKA. We hypothesised that activity expectation fulfillment would be associated with overall satisfaction with TKA outcomes.

Methods: This study comprised secondary data analysis of findings from the SuPeR Knee study. Using conventional content analysis, a classification system of activities specific to our TKA patient cohort was created. At 3 months following TKA, patients rated satisfaction with fulfilling activity goals and pain attenuation. The average level of satisfaction achieved was used as our measure of goal fulfillment. Overall satisfaction of the outcomes of surgery was rated using a 5-point Likert scale and the association between goal fulfillment and overall surgery satisfaction was compared by Spearman's rank correlation.

Results: Data were collected from 861 TKA patients. Recreation and sporting pursuits were found to be important activity types (43% of all activities). At 3 months after surgery, less impactful activities were more commonly satisfied (67%), including domestic and vocational activities, low impact hobbies and leisure activities. Goal fulfillment and improvement in knee pain were both significantly positively correlated to, and significant predictors of, overall patient satisfaction (p≤0.001).

Conclusions: Our Australian cohort of TKA patients have a range of expectations for undertaking high-impact activities after surgery. However, at 3 months after surgery, higher rates of satisfaction were attained for lower-impact activities. Our findings support the importance of identifying activity expectations for each patient and that fulfillment of these goals contributes to overall satisfaction with the outcomes of TKA.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Frequency of satisfaction ratings for each activity class.
Fig 2
Fig 2. Overall satisfaction with outcomes of the surgery 3 months post-TKA.
Fig 3
Fig 3. Expected reduction in knee pain pre-surgery and reported knee pain reduction 3 months post TKA.
See this image and copyright information in PMC

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