Randomized Study to Improve Satisfaction After Knee Replacement Using a Personalized Outcome Prediction Tool and Targeted Mental Health and Physical Therapy

What this Trial Is About

Researchers are evaluating whether using a Personalized Outcome Prediction Tool combined with targeted mental health and physical therapy interventions can improve satisfaction one year after total knee arthroplasty TKA compared to standard care. This randomized controlled trial focuses on patients scheduled for primary TKA who have certain risk profiles indicating potential dissatisfaction based on patient-reported outcome measures PROMs. The goal is to set better expectations and address issues in patients with poor baseline mental health and physical function. Participants are randomly assigned to either standard care or standard care plus the Personalized Outcome Prediction Tool and targeted interventions. The prediction tool uses patient information and baseline PROMs to help set surgery expectations, with results discussed by the surgeon. Those with identified mental health concerns receive further screening and possible psychiatric consultation, while patients with lower physical function scores may undergo a 4 to 8 week pre-surgery physical therapy rehabilitation program. All participants follow the usual TKA care pathway before and after surgery. Throughout the study, participants complete PROMs via MyChart starting 2 to 3 months before surgery. Researchers evaluate satisfaction at one year after surgery, focusing on the proportion of patients reporting dissatisfaction. Assessments include mental health screenings, physical therapy evaluations, and the standard TKA care regimen. The study monitors all patients for 90 days post-operation as part of standard care, and analyses will follow all randomized participants regardless of intervention adherence.

Improving Total Knee Arthroplasty Dissatisfaction Through a Personalized Approach Focusing on PROMs Phenotypes