Patients' experiences and satisfaction at one year following primary total knee arthroplasty: A focus-group discussion.

Objective: To date, no study has explored patients' experiences, outcome expectations and satisfaction 1-year post-total knee arthroplasty (TKA) using focus-group discussion (FGD). The exploration of patients' expectations, functional recovery and limitations may support future modifications and thus improve outcomes post-TKA.

Methods: An FGD was conducted with patients at 1-year post-TKA. Moderators led the discussion using a semistructured discussion guide. The discussion was digitally recorded, transcribed verbatim and analysed to formulate themes.

Results: The study identified four main themes: recovery experience post-TKA, experience before TKA, activity of daily living (ADL) changes post-TKA and post-TKA outcome expectations. The recovery experience theme explores the overall experience post-TKA in terms of symptoms and progression issues; their experience with the orthopaedic surgeon and physiotherapy; and the differences between first and second knee replacements. The experience before TKA theme discusses many issues raised by patients that they believed strongly affected TKA outcomes and their satisfaction, such as the referral process, ADL limitations before TKA and their beliefs about post-TKA outcomes. The ADL changes post-TKA theme discusses the diversity of functional improvements, limitations and new functional ability. The outcome expectation theme explores what the patients expected to gain from surgery and the factors that modified those expectations, and whether their expectations were met.

Conclusions: Patient attitude, sufficient preoperative education, outcome expectation modification, communication with the surgeon and patients taking an active role in rehabilitation can all affect post-TKA outcomes and satisfaction. Hence, the recommendation is to address all of these issues before TKA to enhance outcomes and patient satisfaction.