ArticlePakistan journal of medical sciences2026
Total knee Arthroplasty: Patient expectations and outcomes in a resource constrained setting.
Article in Pakistan journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Knee osteoarthritis significantly impacts the quality of life, particularly in advanced stages. Total knee arthroplasty (TKA) is a common treatment, but 20-30% of patients remain dissatisfied despite clinical improvements. This study evaluates TKA outcomes using patient-reported outcome measures (PROMs) in a low-middle-income country context. Methodology: A prospective cohort study from Aga Khan University Hospital of 70 patients with end-stage knee osteoarthritis undergoing TKA was conducted from May, 2023 to December, 2023, Improvement in Knee injury and Osteoarthritis Outcome Score (KOOS-42) at three months post-TKA was assessed. The secondary objectives were to evaluate the correlation between patient expectations and outcomes, a comparison of unilateral and bilateral TKA, and the effects of patellar resurfacing and home-based physiotherapy. Data were analyzed using Stata 17.0. Results: Significant improvements in KOOS scores were observed three months post-TKA (mean 71.0 ± 7.3, P<0.001) compared to preoperative scores (26.3 [21.6-30]). Patient expectations were higher than actual postoperative outcomes (P<0.001). The pre-operative functional score and Patellar resurfacing improved symptom scores (P=0.003), while other factors like unilateral vs. bilateral TKA and home-based physiotherapy showed no significant impact on overall KOOS scores. Conclusion: TKA significantly improves patient-reported outcomes, but a gap remains between expectations and actual outcomes. Tailored patient education is crucial to manage expectations and enhance satisfaction, especially in resource-limited settings. These findings support the need for patient-centered care approaches in TKA.
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