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สุทธิวรรณ เชวงเกียรติกุล
สุภาพ อารีเอื้อ
พิชญ์ประอร ยังเจริญ
วิโรจน์ กวินวงศ์โกวิท


                The aim of this correlational study was to examine patients’ expectations to postoperative outcomes among older adults undergoing total knee arthroplasty and its related factors. The eighty-four older adults whose ages were sixty and over with severe knee osteoarthritis scheduled for total knee replacement surgery were enrolled. Before getting surgery, participants were asked to complete the Demographic and Health Information Questionnaire, the Knee Injury and Osteoarthritis Outcome Score (KOOS ADL), and the Hospital for Special Surgery Knee Replacement Expectations Survey (HSS-Knee Survey). Data were analyzed using descriptive statistics, independent t-test, and Pearson product moment correlation coefficient.

                The results showed that the participants had a high level of postoperative outcome expectation score (M= 69.41, SD=13.87). When considering each item of their expectations, “regaining walking ability in a short distance” (M=3.69, SD=.51) and “improving psychological well-being" were highly expected (M=3.63, SD=.62). However, “improving sexual activity” (M=.55, SD=1.17) and “being employed for monetary reimbursement” (M=.68, SD=1.38) were the least of expectations. The participants with the difference in gender and preoperative functional ability had significant differences in postoperative outcome expectation score (t=3.363, p=.001, and t=3.911, p=.000, respectively). Moreover, gender and preoperative functional ability were only two factors significantly related to patients’ expectations (rbi=-.348, p=.001 and rp=.382, p=.000, respectively). The study highlights basic information for the healthcare team to understand patients’ expectation after receiving total knee arthroplasty and to design any interventions that could be resulting in patients’ expectation satisfaction and the desired surgical outcomes.


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American Academy of Orthopaedic Surgeons. (2013). Treatment of osteoarthritis of the knee: Evidence-based guideline (2nd ed.). Retrieved from research/guidelines/treatmentofosteoarthr itisofthekneeguideline.pdf

Aree-Ue, S., Roopsawang, I., & Kawinwonggowit, V. (2019). Factors predicting functional ability among older adults undergoing hip and knee arthroplasty. Pacific Rim International Journal of Nursing Research, 23(2), 156-169.

Chaipinyo, K. (2009). Test-retest reliability and construct validity of Thai version of knee osteoarthritis outcome score (KOOS). Thai Journal of Physical Therapy, 31, 67-76.

Chareancholvanich, K. (2016). Scoring systems for total knee arthroplasty. in K. Chareancholvanich (Ed.), Reconstructive surgery of the osteoarthritic knee (pp. 334-343). Bangkok: N. P. Press limited.

Clement, N. D., Macdonald, D., Patton, J. T., & Burnett, R. (2015). Post-operative Oxford knee score can be used to indicate whether patient expectations have been achieved after primary total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 23(6), 1578-1590.

Cross, M., Smith, E., Hoy, D., Nolte, S., Ackerman, I., Fransen, M., . . . Laslett, L. L. (2014). The global burden of hip and knee osteoarthritis: Estimates from the global burden of disease 2010 study. Annals of the rheumatic diseases, 73(7), 1323-1330.

Doungthipsirikul, S., Sirisamutr, T., Tantipisitkul, K., Ingsrisawang, L., & Teerawattananon, Y. (2013). Thai elderly health survey report 2013. Retrieved from

Ghomrawi, H. M., Mancuso, C. A., Westrich, G. H., Marx, R. G., Mushlin, A. I., & Expectations Discordance Study Group. (2013). Discordance in TKA expectations between patients and surgeons. Clinical Orthopaedics and Related Research, 471(1), 175-180.

Goldsmith, L. J., Suryaprakash, N., Randall, E., Shum, J., MacDonald, V., Sawatzky, R., . . . Bryan, S. (2017). The importance of informational, clinical and personal support in patient experience with total knee replacement: A qualitative investigation. BMC musculoskeletal disorders, 18(1), 127. doi: 10.1186/s12891-017-1474-1478

Gunaratne, R., Pratt, D. N., Banda, J., Fick, D. P., Khan, R. J., & Robertson, B. W. (2017). Patient dissatisfaction following total knee arthroplasty: A systematic review of the literature. The Journal of arthroplasty, 32(12), 3854-3860.

Hooper, G., Lee, A., Rothwell, A., & Frampton, C. (2014). Current trends and projections in the utilisation rates of hip and knee replacement in New Zealand from 2001 to 2026. The New Zealand Medical Journal, 127(1401), 82-93.

Kawinwonggowit, V. (2015). Osteoarthritic knee (chapter 1) by Faculty of Medicine Ramathibodi Hospital. Retrieved from https://www.thairath.

Koenen, P., Bäthis, H., Schneider, M. M., Fröhlich, M., Bouillon, B., & Shafizadeh, S. (2014). How do we face patients' expectations in joint arthroplasty? Archives of Orthopaedic and Trauma Surgery, 134(7), 925-931.

Kulsutthi, S., Wongsa, P., & Fukfon, K. (2017). Effects of discharge planning on quality of life and physical function among patients receiving total knee arthroplasty surge. Journal of Nursing, Public Health, and Education, 18(3), 63-72.

Kuptniratsaikul, V. (2016). Postoperative rehabitation after total knee arthroplasty. in K. Chareancholvanich (Ed.), Reconstructive surgery of the osteoarthritic knee (pp. 321-333). Bangkok: N. P. Press limited.

Kuroda, Y., Matsumoto, T., Takayama, K., Ishida, K., Kuroda, R., & Kurosaka, M. (2016). Subjective evaluation before and after total knee arthroplasty using the 2011 Knee Society Score. The Knee, 23(6), 964-967.

Kurtz, S. M., Ong, K. L., Lau, E., & Bozic, K. J. (2014). Impact of the economic downturn on total joint replacement demand in the United States: Updated projections to 2021. The Journal of Bone Joint Surgery, 96(8). 624-630.

Mancuso, C. A., Sculco, T. P., Wickiewicz, T. L., Jones, E. C., Robbins, L., Warren, R. F., & Williams-Russo, P. (2001). Patients' expectations of knee surgery. The Journal of Bon & Joint Surgery, 83(7), 1005-1012.

Neuprez, A., Delcour, J. P., Fatemi, F., Gillet, P., Crielaard, J. M., Bruyère, O., & Reginster, J. Y. (2016). Patients’ expectations impact their satisfaction following total hip or knee arthroplasty. PLoS One, 11(12), e0167911.

Parker, K., Horowitz, J., & Stepler, R. (2017). American see different expectations for men and women. Retrieved from https://www.pewsocialtrends. org/2017/12/05/americans-see-different-expectations-for-men-and-women/

Pongsupap, Y., & Van Lerberghe, W. (2011). People‐centred medicine and WHO's renewal of primary health care. Journal of Evaluation in Clinical Practice,17(2), 339-340.

Poultsides, L. A., Ghomrawi, H. M., Lyman, S., Aharonoff, G. B., Mancuso, C. A., & Sculco, T. P. (2012). Change in preoperative expectations in patients undergoing staged bilateral primary total knee or total hip arthroplasty. The Journal of arthroplasty, 27(9), 1609-1615.

Prieto-Alhambra, D., Judge, A., Javaid, M. K., Cooper, C., Diez-Perez, A., & Arden, N. K. (2014). Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: Influences of age, gender and osteoarthritis affecting other joints. Annals of the rheumatic diseases, 73(9), 1659-1664.

Ramathibodi Hospital Information System. (2019). Patients with total knee replacement in 2016-2018. Faculty of Medicine Ramathibodi Hospital, Mahidol University.

Scott, C. E. H., Bugler, K. E., Clement, N. D., MacDonald, D., Howie, C. R., & Biant, L. C. (2012). Patient expectations of arthroplasty of the hip and knee. The Journal of bone and joint surgery, 94(7), 974-981.

Tanavalee, A. (2014). Knee osteoarthritis. in A. Tanavalee, S. Ngarmukos, Y. Wangroongsub (Ed.), Textbook of core orthopedic knowledge for medical doctor (pp. 56-65). Bangkok: Department of Orthopaedics Faculty of Medicine Chulalongkorn University limited.

Trongsakul, S., Lambert, R., Clark, A., Wongpakaran, N., & Cross, J. (2015). Development of the Thai version of Mini‐Cog, a brief cognitive screening test. Geriatrics & Gerontology International, 15(5), 594-600.

Umehara, T., & Tanaka, R. (2018). Effective exercise intervention period for improving body function or activity in patients with knee osteoarthritis undergoing total knee arthroplasty: A systematic review and meta-analysis. Brazilian Journal of Physical Therapy, 22(4), 265-275.

Woratanarat, P. (2014). Lifestyles and Knee Osteoarthritis. Retrieved from th/books/วิถีชีวิตกับโรคข้อเข่าเสื่อม

Zywiel, M. G., Mahomed, A., Gandhi, R., Perruccio, A. V., & Mahomed, N. N. (2013). Measuring expectations in orthopaedic surgery: A systematic review. Clinical Orthopaedics and Related Research, 471(11), 3446-3456.