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March 14, 2026Open Access

The Rollercoaster of Recovery: Changes in patient satisfaction after total knee arthroplasty in the prospective FInGK study

LSLisa SchwarzkopfCarl von Ossietzky Universität Oldenburg HJHannes JacobsCarl von Ossietzky Universität Oldenburg UMUwe MausDüsseldorf University Hospital

Key Points

The study aims to analyze early changes in patient satisfaction after total knee arthroplasty and associated biopsychosocial factors.
Conducted as a prospective cohort study with 227 patients undergoing elective TKA.
Data collected preoperatively and at two and twelve months postoperatively using self-reported questionnaires.
Patients categorized into four satisfaction groups based on their satisfaction changes over time.
Overall improvements in WOMAC Score from 47.3 to 76.5 and WHO-5 Score from 43.7 to 66.4 at twelve months postoperatively.
One third of patients reported dissatisfaction at twelve months, particularly younger individuals and smokers.
21.9% of patients experienced changes in satisfaction levels between t1 and t2.

Abstract

Background and Objective Despite favorable objective outcomes, 20% of patients report dissatisfaction after total knee arthroplasty (TKA). This study analyzed early changes in patient satisfaction and associated biopsychosocial parameters from two to twelve months postoperatively. Methods The FInGK study was a prospective cohort study including 227 patients who underwent elective TKA between December 2019 and May 2021 at a German university hospital. Data were collected preoperatively (t0), as well as at two (t1) and twelve months (t2) postoperatively via self-reported questionnaires including Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Score), WHO Well-Being Index (WHO-5 Score), and patient satisfaction. Patients were stratified into four satisfaction groups (Satisfied/Satisfied (n=129), Not-Satisfied/Satisfied (n=23), Satisfied/Not-Satisfied (n=26), Not-Satisfied/Not-Satisfied (n=46)) based on their satisfaction pattern at t1 and t2. Results Overall minimally clinically important improvements in WOMAC Score (47.3 to 69.0 to 76.5) and improvements in WHO-5 Score (43.7 to 59.1 to 66.4) were observed in the total study population from preoperative to two and twelve months postoperatively. One third of patients reported dissatisfaction at twelve months, being significantly younger (66.5 vs. 69.1 years; p=0.046) and more smokers (16.2 % vs. 6.5%; p=0.021). 21.9% experienced satisfaction changes: 11.6% switched from satisfied (t1) to dissatisfied (t2). Conversely, 10.3% improved from dissatisfied to satisfied, demonstrating gains between t1 and t2. Conclusion We identified a variety of patient groups, each exhibiting distinct levels of satisfaction and biopsychosocial profiles after TKA. Further studies with larger sample sizes are needed to examine early postoperative outcomes and changes over time after TKA.

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