The Truth About TKA Satisfaction: Why Machine Learning Beats Traditional Stats

A retrospective review of 897 total knee arthroplasties compares binary logistic regression with stochastic gradient boosting to uncover why patients are unhappy.

Patient satisfaction following total knee arthroplasty (TKA) has been stagnant at around 80% without a clear understanding of the lingering 20% dissatisfaction. Satisfaction is a prominent topic in the literature, yet it remains a convoluted topic to understand. Factors reported to influence satisfaction in systematic reviews are meeting patient expectations, reduction in preoperative pain, and depression and anxiety. Other factors include medial flexion gap laxity, food received during a hospital stay, and even the use of therapy dogs.

Nonetheless, government payers have increased interest in basing surgeon reimbursement on patient satisfaction without a full understanding of the contributory factors. Therefore, it is imperative to identify the factors that influence patient satisfaction.