Musculoskeletal Health Literacy is Associated with Outcome and Satisfaction of Total Knee Arthroplasty

Abstract Introduction The purpose of this study was to investigate if there is an association between musculoskeletal health literacy with outcome and satisfaction after total knee arthroplasty (TKA). Methods A cross-sectional study was performed at our tertiary center to include patients between one and six years post-operatively after primary TKA. Patients were provided a survey including basic demographics, validated musculoskeletal health literacy scale (LiMP), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and TKA satisfaction (whether they would choose to undergo the same operation again). Patients were categorized as either low or normal health literacy based on number of questions (cutoff six out of nine) answered correctly on the LiMP. Statistical analysis included multivariate regression with significance at p Results 453 individuals fully completed the survey of eligible participants. 296 individuals (65.3%) had normal health literacy and 157 individuals (34.7%) had low health literacy. Average WOMAC (/96) was 18.0±19.7 in the low and 12.1±15.4 in the normal health literacy groups. Patients with low health literacy had significantly higher WOMAC (worse function) compared to those with normal health literacy (p=0.001). Patients with normal musculoskeletal health literacy were significantly more likely to undergo the same operation again (p=0.01, Odds Ratio 2.163). Conclusions This study shows that patients with a low musculoskeletal health literacy have worse outcome scores and are less likely to be satisfied with their TKA. By identifying these patients pre-operatively, emphasis can be placed on enhancing procedure expectations and understanding in order to improve outcome measures and overall satisfaction.