Michael J. Dunbar, MD, reviewed information regarding managing expectations for knee replacement at the recent Knee Society meeting in Orlando, Florida on March 5, 2016. He noted that unmet expectations after knee replacement have been shown to be one of the largest determinants of dissatisfaction following the procedure. Educating patients and managing their expectations preoperatively requires a discussion between the patient and surgeon as to what the patient anticipates following the operation. Patients should be cautioned that it is normal to have some residual pain after knee replacement, particularly after activity, and that some functions, such as kneeling and climbing ladders, may be more difficult. In addition to managing the expectations, a recent study demonstrated the relationship between less severe arthritis of the knee and persistent pain and dissatisfaction after knee replacement. It has also been noted that a high percentage of patients referred for unexplained pain after knee replacement surgery had a lesser grade of arthritis in their knee preoperatively. It has also been noted that patients with less severe arthritis may be at higher risk for persistent pain.
Having a discussion with the patient about the anticipated expectations and outcomes and ensuring that the patient has been through appropriate nonoperative care, particularly if they have less severe arthritis, are important factors to minimize the risk of pain and dissatisfaction after knee replacement.