One-Year Postoperative Patient-Reported Outcome Measures Are Associated With Three-Year to Five-Year Postoperative Satisfaction in Total Knee Arthroplasty

BACKGROUND: Over the past couple of decades, the definition of success after total knee arthroplasty (TKA) has shifted away from clinician-rated metrics and toward the patient's subjective experience. Therefore, understanding the aspects of patient recovery that drive 3-year to 5-year satisfaction after TKA is crucial. The aims of this study were to (1) determine the 1-year postoperative factors, specifically patient-reported outcome measures (PROMs) that were associated with 3-year and 5-year postoperative satisfaction and (2) understand the factors that drive those who are not satisfied at 1 year postoperatively to become satisfied later in the postoperative course.

METHODS: This was a retrospective study of 402 TKA patients who were gathered prospectively and presented for their 1-year follow-up. Demographics were collected preoperatively and patient-reported outcomes were collected at 1, 3, and 5 years postoperatively. Logistic regressions were used to identify the factors at 1 year that were associated with 3-year and 5-year satisfaction.

RESULTS: Associations between 1-year PROMs with 3-year satisfaction were observed. Longer term satisfaction at 5 years was more closely associated with EuroQol 5 Dimension Mobility, Activity Score, and Numerical Rating Scale Satisfaction. Of those who were not satisfied at 1 year, EuroQol 5 Dimension Mobility, Knee Disability Osteoarthritis Outcome Score Function in Sport and Recreation, and Satisfaction were associated with becoming satisfied at 3 years.

CONCLUSION: The 1-year PROMs were found to be associated with satisfaction at 3 to 5 years after TKA. Importantly, many of the PROMs that were associated with 3-year to 5-year satisfaction, especially in those who were not originally satisfied at 1 year, were focused on mobility and activity level.