Abstract: BACKGROUND: Patients’ postoperative satisfaction is determined by many factors, and psychological factors may play an important role; at present, few studies have shown the effect of personality classification on patient satisfaction and clinical outcome after total knee arthroplasty. Identifying and determining these factors in patients can carry out educational intervention and expectation management according to the specific personality types of patients, so as to improve overall satisfaction.
OBJECTIVE: To investigate the impact of personality traits on the subjective outcome of total knee arthroplasty.
METHODS: We investigated 108 patients undergoing total knee arthroplasty. Patients were divided into satisfied group (n=82) and unsatisfied group (n=26) based on the patient satisfaction obtained during the follow-up. The Eysenck Personality Questionnaire-Revised Short Scale for Chinese was used to test the personality characteristics of patients. Knee-specific measurements included the American Hospital for Special Surgery Knee Score, Knee Society Score (clinical and functional scores) and the visual analogue scale score before and one year after surgery.
RESULTS AND CONCLUSION: (1) None of the follow-up patients had postoperative complications requiring revision surgery. 76% of patients were satisfied and 24% were not satisfied. (2) Among them, personality characteristics were divided into four types: 93% of patients with “extroversion-stable” personality were satisfied and 7% were dissatisfied; 40% of patients with “extroversion-unstable” personality were satisfied, and 60% were dissatisfied; 87% of patients with “introverted-stable” personality were satisfied and 13% were dissatisfied; 47% of patients with “introverted-unstable” personality were satisfied and 53% were dissatisfied; the difference was statistically significant (P < 0.05). (3) At 1 year postoperatively, American Hospital for Special Surgery Knee Score was significantly higher in the satisfied group than in the unsatisfied group (P < 0.05). Visual analogue scale score was significantly lower in the satisfied group than in the unsatisfied group (P < 0.05). Clinical and functional scores of Knee Society Score were not significantly different between the satisfied and unsatisfied groups        (P > 0.05). (4) Multivariate Logistic regression analysis showed that patient personality and postoperative pain were independent risk factors that affected patient satisfaction. (5) It is concluded that personality characteristics may affect patient satisfaction and clinical outcomes after total knee arthroplasty. Therefore, the personality characteristics of patients may be a useful predictor of satisfaction after total knee arthroplasty. This feature is important for patients preparing for total knee arthroplasty, because we can provide targeted education and management to improve their prognosis.

Key words: knee, joint, replacement, personality, satisfaction, pain