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. 2025 Sep;23(3):e70178.
doi: 10.1002/msc.70178.

A Qualitative Study to Explore Patient Expectations of Recovery After Total Knee Replacement Surgery

Saurabh P Mehta  1 , Liane M Ventura  2 , James D Boone  1 , Ali Oliashirazi  3
Affiliations

A Qualitative Study to Explore Patient Expectations of Recovery After Total Knee Replacement Surgery

Saurabh P Mehta et al. Musculoskeletal Care. 2025 Sep.

Abstract

Introduction: Total knee replacement (TKR) is a common intervention for end-stage knee osteoarthritis; however, some patients report dissatisfaction despite favourable clinical outcomes. Patient expectations are increasingly recognized as key contributors to postoperative satisfaction. These expectations often shape perceptions of success and influence recovery experiences, making them a critical focus for preoperative care and counselling.

Objectives: This study aimed to explore the pre-operative expectations of individuals scheduled for TKR, focusing on their anticipated recovery outcomes and perceived improvements in daily life.

Methods: A qualitative descriptive design was used. Semi-structured interviews were conducted with nine participants (mean age 65.1 years) awaiting primary TKR at an academic orthopaedic clinic. The interviews were audio-recorded, transcribed verbatim, and analysed using inductive content analysis. Codes were categorised using the International Classification of Functioning, Disability and Health (ICF) framework to identify key expectation domains and thematic patterns.

Results: Participants expressed strong expectations for pain relief, improved mobility, and re-engagement in meaningful activities. Expectations were grouped into contextual factors, body structure/function, activity, and participation. Many anticipated returning to hobbies, social roles, and work, often hoping to regain independence and emotional well-being. Some expectations, such as complete pain elimination or full functional restoration, may exceed typical postoperative outcomes.

Conclusion: Understanding patient expectations before TKR is essential for aligning clinical care with patient-centred outcomes. Preoperative counselling should address both physical and psychosocial aspects of recovery to realistically manage expectations. These findings support the development of tailored educational and decision-making interventions to enhance satisfaction and recovery experiences.

Keywords: expectations; knee osteoarthritis; qualitative study; total knee replacement.

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