Only Low Patients' Expectations Are Prognostic for Dissatisfaction With Performing Work-Related Knee-Straining Activities After Total Knee Arthroplasty: A Prospective Multicenter Cohort Study

Yvonne van Zaanen, Tessa Siertsema, Arthur J Kievit, Rutger C I van Geenen, Thijs M J Pahlplatz, Marco J M Hoozemans, Leendert Blankevoort, Matthias U Schafroth, Daniel Haverkamp, Ton M J S Vervest, Dirk H P W Das, Vanessa A Scholtes, P Paul F M Kuijer

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


OBJECTIVE: To investigate whether preoperative expectations regarding performing work-related knee-straining activities were associated with being dissatisfied 6 months after total knee arthroplasty (TKA) among working patients, and, to identify prognostic factors for being dissatisfied with performing these work-related knee-straining activities.

DESIGN: Multicenter prospective cohort study.

SETTING: Orthopedic surgery departments of 7 hospitals in the Netherlands.

PARTICIPANTS: A consecutive sample of 175 working patients who were on the waiting list for TKA (median age 59 years, 53% women) and intended to return to work (N=175).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURE(S): Dissatisfaction with performing work-related knee-straining activities 6 months postoperative was measured using the Work Osteoarthritis or joint-Replacement Questionnaire (score range 0-100). The clinically relevant cut-off points for being satisfied and dissatisfied were ≥71 and ≤50, respectively.

RESULTS: Thirty-three patients (19%) were dissatisfied with performing work-related knee-straining activities 6 months after TKA. Patients who expected to be dissatisfied preoperative had a 5.1 times higher odds (95% CI 1.7-15.5) of being dissatisfied 6 months postoperatively compared with patients who expected to be satisfied preoperative. Regression analyses revealed that only patients' expectations were prognostic for being dissatisfied 6 months postoperatively rather than age, pain level, or having a knee-straining job.

CONCLUSIONS: Two in 10 working patients are dissatisfied with performing work-related knee-straining activities 6 months after TKA. Only preoperative patients' expectations appeared prognostic. Therefore, we should better prepare working patients with low expectations by managing their preoperative expectations and improving their performance of work-related knee-straining activities in rehabilitation.

Original languageEnglish
Pages (from-to)2051-2058
Number of pages8
JournalArchives of physical medicine and rehabilitation
Issue number12
Early online date2 Jun 2023
Publication statusPublished - Dec 2023


  • Arthroplasty
  • Knee
  • Motivation
  • Patient Reported Outcome Measure
  • Patient satisfaction
  • Rehabilitation
  • Replacement

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