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This study identifies optimal OKS values that discriminate post-operative (TKA) patient satisfaction and determines the variation in threshold values by patient characteristics and expectations. It is the first to identify patient improvement using measures (PoPC) that account for patient's pre-operative symptom severity. Of 365 primary TKA patients from a London district general hospital 84% were satisfied at 12 and 24 months. Whilst the overall OKS thresholds (follow-up, change, PoPC) were stable at 12 months (31, 11, 39.7%) and 24 months (35, 12, 38.9%), patients who were older (≥75years), were underweight/normal (BMI<25), had pre-operative symptom severity (OKS≤15) and expected no pain post-surgery, required a greater (potential) improvement to be classed as satisfied. When reporting good patient outcomes, cohorts should be stratified accordingly.

Original publication




Journal article


J Arthroplasty

Publication Date





1364 - 1371


Oxford Knee Score, PoPC, knee arthroplasty, patient reported outcomes, satisfaction, Aged, Arthroplasty, Replacement, Knee, Cohort Studies, Female, Follow-Up Studies, Humans, London, Male, Middle Aged, Osteoarthritis, Knee, Pain, Patient Outcome Assessment, Patient Satisfaction, Postoperative Period, Research Design, Surveys and Questionnaires, Symptom Assessment, Time Factors