Lim Wei Ze, Noviani Maria, Yeo Seng-Jin, Wong Steven Bak-Siew, Wylde Vikki, Tan Mann Hong, Pang Hee Nee, Tay Darren, Thumboo Julian, Leung Ying-Ying
Department of Rheumatology & Immunology, Singapore General Hospital, The Academia, Level 4, 20 College Road, Singapore, 169856, Singapore.
Department of Orthopedic Surgery, Singapore General Hospital, Singapore, Singapore.
Sci Rep. 2025 Apr 30;15(1):15133. doi: 10.1038/s41598-025-91492-0.
We aimed to evaluate the relationship between patient expectations and outcomes after knee arthroplasty (KA) in an Asian population in Singapore. We recruited consecutive patients with severe knee osteoarthritis (KOA) scheduled for KA. Pre-operatively, patients provided socio-demographic data and completed the Hospital for Special Surgery Knee Replacement Expectations Survey (HSS-KRES) for baseline pre-operative expectations and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for baseline pain and function. Telephone interviews were conducted at 6- and 12-months post-operatively to collect the WOMAC, satisfaction with KA, and the extent to which pre-operative expectations had been fulfilled. We included 1136 patients (mean age 65.9 years, 69.9% female), of which 1103 and 1089 completed the telephone interviews at 6- and 12-months post-KA respectively. In the multivariable models, expectation fulfilment was consistently associated with improvements in WOMAC pain and function at 6- and 12-months post-operatively, but not the baseline expectations. In the sensitivity analyses, expectation fulfilment was also found to be significantly associated with the achievement of minimal clinically important difference (MCID) for WOMAC pain and function at both 6- and 12-months. Expectation fulfilment was associated with patient satisfaction in the adjustment models at both 6- and 12-months after KA. The fulfilment of expectations, rather than pre-operative expectations, is associated with improvements in WOMAC pain, function and overall satisfaction at 6- and 12-months after KA.
我们旨在评估新加坡亚洲人群中膝关节置换术（KA）后患者期望与治疗结果之间的关系。我们招募了计划接受KA的连续性重度膝关节骨关节炎（KOA）患者。术前，患者提供社会人口统计学数据，并完成特殊外科医院膝关节置换期望调查（HSS-KRES）以了解术前基线期望，以及西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以了解基线疼痛和功能情况。术后6个月和12个月进行电话访谈，收集WOMAC、对KA的满意度以及术前期望的实现程度。我们纳入了1136例患者（平均年龄65.9岁，69.9%为女性），其中1103例和1089例分别在KA术后6个月和12个月完成了电话访谈。在多变量模型中，期望实现与术后6个月和12个月时WOMAC疼痛和功能的改善始终相关，但与基线期望无关。在敏感性分析中，还发现期望实现在术后6个月和12个月时均与WOMAC疼痛和功能达到最小临床重要差异（MCID）显著相关。在KA术后6个月和12个月的调整模型中，期望实现与患者满意度相关。期望的实现，而非术前期望，与KA术后6个月和12个月时WOMAC疼痛、功能及总体满意度的改善相关。
