Patient reported satisfaction following 1578 primary total knee arthroplasties in different ethnic groups in Leicester: are Caucasian patients more satisfied?


  • Mehdi Suzangar Post Arthroplasty Fellowship, University Hospitals of Leicester, Leicester
  • Colin Esler Trauma and Orthopaedic, University Hospitals of Leicester, Leicester
  • James Kennedy Trauma and Orthopaedic, University Hospitals of Leicester, Leicester
  • Urjit Chatterji Trauma and Orthopaedic, University Hospitals of Leicester, Leicester



Patient satisfaction, Total knee arthroplasty, TKR, Ethnicity, Ethnic groups


Background: Several non-UK and non-European studies, have suggested differences in post-operative outcome measures, including patient satisfaction, following total knee arthroplasty (TKA) when assessed against ethnicity. The aim of our study was to assess patient reported satisfaction following primary TKA in an ethnically diverse part of the UK, Leicestershire, to find out whether the Caucasian patients were more satisfied compared to non-Caucasians.

Methods: Using our regional joint Registry, the Trent and Wales Arthroplasty Audit Group (TWAAG) registry, a retrospective analysis of the prospectively collected patients’ reported satisfaction following primary TKA was performed. 1578 patients from Leicester province who had undergone their first TKA in Leicester between 1990 and 2007, and who had responded to their 12 month validated post-operative questionnaires were included.

Results: Overall patient reported satisfaction was 87.6%. Patient satisfaction was 87.7% in ‘British White’, 92.4% in ‘Other White’, 83.5% in ‘Indian/Pakistani’ population. When categorising patient ethnicity to ethnic groups, reported satisfaction was 88.1% in the ‘Caucasian’ group and 83.4% in the ‘non-Caucasian’ groups. Fisher’s exact test did not indicate a statistically significant difference in the reported satisfaction between these ethnic groups.

Conclusions:In our study, ethnicity was not a significant attributing factor in patient reported satisfaction following primary TKA. 


Author Biography

Mehdi Suzangar, Post Arthroplasty Fellowship, University Hospitals of Leicester, Leicester

Senior Hip and Knee Arthroplasty Fellowship


Drexler M, Dwyer T, Chakravertty R, Farno A, Backstein D. Management factorials in total knee replacement. Assuring the happy total knee replacement patient. Bone Joint J. 2013;95:120–3.

Hamilton DF, Lane JV, Gaston P, Patton JT, MacDonald D, Simpson AHRW, et al. What determines patient satisfaction with surgery? A prospective cohort study of 4709 patients following total joint replacement. BMJ Open. 2013;3.

Kim TK, Kwon SK, Kang YG, Chang CB, Seong SC. Functional Disabilities and Satisfaction After Total Knee Arthroplasty in Female Asian Patients. The J Arthroplasty. 2010;25(3):458-64.

Anderson JG, Wixson RL, Tsai D, Stulberg SD, Chang RW. Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty. 1996;11:831-40.

Baker PN, van der Meulen JH, Lewsey J, Gregg PJ. National Joint Registry for England and Wales. The role of pain and function in determining patient satisfaction after total knee replacement: data from the National Joint Registry for England and Wales. J Bone Joint Surg Br. 2007;89:893-900.

Baker PN, Rushton S, Jameson SS, Reed M, Gregg P, Deehan DJ. Patient satisfaction with total knee replacement cannot be predicted from Pre-operative variables alone. A cohort study from the national joint registry for England and Wales. Bone Joint J 2013;95:1359–65.

Brokelman RB, van Loon CJ, Rijnberg W. Patient versus surgeon satisfaction after total hip arthroplasty. J Bone Joint Surg Br. 2003;85:495-8.

Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clinical Orthop Relat Res. 2010;468(1):57-63.

Lingard EA, Sledge CB, Learmonth ID. Patient expectations regarding total knee arthroplasty: differences among the United States, United Kingdom, and Australia. J Bone Joint Surg [Am]. 2006;88:1201-7.

Mancuso CA, Jout J, Salvati EA, Sculco TP. Fulfilment of patients’ expectations for total hip arthroplasty. J Bone Joint Surgery [Am]. 2009;91(A):2072-8.

Nilsdotter AK, Toksvig-Larsen S, Roos EM. Knee arthroplasty: are patients’expectations fulfilled? a prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop. 2009;80:55-61.

Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 2006;452:35-43.

Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000;71:262-7.

Scott CEH, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement. A prospective study of 1217 patients. J Bone Joint Surg [Br]. 2010;92:1253-8.

Scott CE, Bugler KE, Clement ND, Macdonald D, Howie CR, Biant LC. Patient expectations of arthroplasty of three hip and knee. J Bone Joint Surg Br. 2012;94:974-81.

Leedham B, Meyerowitz BW, Muirhead J. Frist WH. Positive expectations predict health after heart transplantation. Health Psychol. 1995;14:74-9.

Joshy S, Datta A, Perera A, Thomas BGN, Singh BK. Ethnic differences in preoperative function of patients undergoing total knee arthroplasty. International Orthopaedics 2006;30:426-8.

Siow WM, Chin PL, Chia SL, Lo NN. Comparative Demographics, ROM, and Function after TKA in Chinese, Malays, and Indians. Clinical Orthopaedics and Related Research 2013;471:1451-7.

Gandhi R, Dhotar H, Razak F, Tso P, Davey JR, Mahomed NN. Predicting the longer term outcomes of total knee arthroplasty. Knee 2010;17(1):15-8.

Ibrahim S, Stone R, Cohen P, Fine M, Henderson W, Khuri S, et al. Racial/ethnic differences in surgical outcomes in veterans following knee and hip arthroplasty. Arthritis Rheum. 2005;52:3143-51.

Kamath AF, Horneff JG, Gaffney V, Israelite CL, Nelson CL. Ethnic and Gender Differences in the Functional Disparities after Primary Total Knee Arthroplasty. Clin Orthop Relat Res. 2010;468:3355–61.

Laverrnia CJ, Alcerro JC, Contreras JS, Rossi MD. Ethinic and racial factors influencing well-being, perceived pain, and physical function after primary total joint arthroplasty. Clin Orthop Relat Res. 2011;469:1838-1845.

Roberts VI, Esler CNA, Harper WM. A 15 year follow-up study of 4606 primary total knee replacements. JBJS (Br). 2007;89(11):1452-6.

Hepinstall MS, Rutledge JR, Bornstein LJ, Mazumdar M, Westrich GH. Factors that impact expectations before total knee arthroplasty. J Arthroplasty. 2011;26(6):870-6.

Brokelman RB, van Loon CJ, Rijnberg W. Patient versus surgeon satisfaction after total hip arthroplasty. J Bone Joint Surg [Br]. 2003;85:495-8.






Original Research Articles