Negative impact of waiting time for primary total knee arthroplasty on satisfaction and patient-reported outcome

Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Fernando A. Miralles-Muñoz, Luis Marco-Gomez, Fernando A. Lopez-Prats

The primary objective of this study was to evaluate the influence of the time on waiting list for total knee arthroplasty (TKA) on the post-operative satisfaction and patient-reported outcomes. This was a prospective observational study of 192 patients followed for one year. Patients were pre and post-operatively assessed with the 12-item Short-Form, reduced Western Ontario MacMaster University, and Knee Society scores. In addition, the Hospital Anxiety and Depression scale was used at time of admission, and patient satisfaction on a five point Likert scale at one post-operative year. Univariate and multivariate analyses were performed. Patients waiting longer than six months had significantly worse pre-operative anxiety score as well as post-operative SF12 (both physical and mental) and KSS-function scores compared to those with a waiting time shorter than six months. Dissatisfaction rate was also higher in patients waiting longer than six months, and it was mainly influenced by pre-operative anxiety and depression. Waiting time longer than six months negatively influenced post-operative satisfaction and patient-related outcome at one year after TKA. These findings may have important clinical implications regarding the prioritization of patients on wait lists or for optimization of treatment while patients wait for surgery related to the management of the mental health and anxiety in order to reduce post-operative dissatisfaction and improve patient-reported outcomes.