Factors Related to Expectations in Individuals Waiting for Total Knee Arthroplasty

Purpose: There is no consensus on how age and expectations influence planning for total knee arthroplasty (TKA). This study developed and evaluated a new expectation questionnaire and assessed the relationship between preoperative expectations and patient characteristics. Method: The questionnaire evaluated expectations for mobility, pain, participation, and rate of recovery after surgery. Fifty-five participants completed a six-minute walk test and expectation questionnaire prior to TKA; 17 participants repeated the questionnaire one week later for reliability testing. Analysis of the questionnaire included intra-class correlation coefficient (ICC), homoscedasticity, skewness, kurtosis, multicollinearity, and descriptive measures. A four-step hierarchical linear regression was completed to determine the relationship of patient age, BMI, previous contralateral TKA, and six-minute walk scores to expectations. Results: The questionnaire showed good/high test-retest reliability (ICC 0.84, 95% CI of 0.57 to 0.94; p > 0.001). The final model was significant in predicting expectation scores R-2 = 0.19 (p = 0.017). Conclusions: This questionnaire reliably measures patient expectations before TKA; however, further research is needed. Although we anticipated younger age to be related to higher expectations, higher function prior to TKA appears to be more strongly associated with higher expectations.