Functional Disabilities and Satisfaction After Total Knee Arthroplasty in Female Asian Patients

Authors: Kim et al. (2010)

Link: https://doi.org/10.1016/j.arth.2009.01.018

Background Information:

Total knee arthroplasty (TKA), or knee replacement surgery, is widely used to treat severe osteoarthritis and relieve chronic pain. While most patients find significant relief, some struggle with everyday movements requiring deep knee bending—like kneeling, squatting, or sitting cross‑legged. This can be especially limiting in many Asian lifestyles, where such activities are culturally common. Female Asian patients, who often undergo TKA, may experience specific challenges in these "high-flexion" activities, making it important to understand both their physical abilities and how happy they are with the surgery.

Purpose of the Study:

The researchers set out to assess how well female Korean patients function after knee replacement surgery and how satisfied they are with the outcome. They wanted to identify which physical activities are most problematic post-surgery, see which of those issues matter most to patients, and find out whether difficulties in certain movements affect overall satisfaction. Their goal was to help surgeons better prepare patients and tailor rehabilitation to meet cultural and functional priorities.

Methods and Data Analysis:

The study surveyed 261 women who had undergone TKA at least a year earlier. These patients filled out a questionnaire rating how difficult they found various daily activities (like kneeling or walking), how important each activity was to them, and how satisfied they were overall. Researchers then compared activity scores between patients who were satisfied and those who were not, analyzing whether greater difficulty in specific movements linked to dissatisfaction.

Key Findings and Conclusions:

The women reported the toughest challenges in kneeling, squatting, sitting cross‑legged, sexual activity, and recreational pursuits—typical high-flexion movements. However, when they ranked which difficulties mattered most, walking, using a bathtub, working, climbing stairs, and recreation took priority. The authors found that, in general, difficulty with bending activities didn’t strongly affect satisfaction. Overall satisfaction was high, with just under 9% reporting dissatisfaction. Those who were unhappy tended to struggle more across most activities and, importantly, gave higher importance to those high-flexion tasks. The study concluded that while high-flexion issues are common, they don’t necessarily lower satisfaction unless patients place great value on them.

Applications & Limitations:

These findings suggest that most female Asian patients recover well enough for daily living post-TKA, even if they can’t perform deep-bending movements. However, patients who highly value these activities may be less satisfied, highlighting the need for clinicians to discuss cultural and lifestyle factors before surgery. Limitations include reliance on self-reported questionnaires, a focus on a single ethnicity and gender, and lack of objective movement measurements. Future work could explore rehabilitation tailored to improve high-flexion outcomes or include diverse patient groups to validate these findings across populations.