How Likely Do Patients After Total Knee Arthroplasty with a Posterior-Stabilized Knee System Meet Their Desired Sport Activity Level?

<b>Background/Objectives</b>: While most patients resume sports within one year after total knee arthroplasty (TKA), data on whether patients achieve their desired level of sports activity remain limited. This study aimed to evaluate the relationship between desired sports activity levels and postoperative outcomes after TKA and to identify factors associated with achieving the desired activity level. <b>Methods</b>: This retrospective cohort study included 280 patients (63.9% female; mean age, 65.7 years) who underwent primary TKA with a mean follow-up of 28.2 months. The University of California and Los Angeles (UCLA) activity score was used pre- and postoperatively to assess the desired and the achieved activity level. <b>Results:</b> The mean UCLA activity score improved significantly after surgery (from 4.6 to 5.6; <i>p</i> < 0.001). However, the mean preoperative desired UCLA score was significantly higher than the mean postoperative achieved UCLA score (7.1 vs. 5.6; <i>p</i> < 0.001). Overall, 34.6% of patients reached their desired activity level. These patients demonstrated a significantly lower preoperative desired UCLA score (6.1 vs. 7.6; <i>p</i> < 0.001) and a higher postoperative achieved UCLA score (6.7 vs. 5.0; <i>p</i> < 0.001) compared with patients who did not. Male sex, higher preoperative UCLA scores, and lower preoperative desired UCLA scores were identified as independent predictors of achieving the desired activity level. <b>Conclusions</b>: The present study demonstrated that despite excellent Knee Society function and WOMAC scores only 1/3 of patients reach their sport-related desired activity level. Surgeons must ensure that they communicate realistic expectations to patients prior to surgery, in order to avoid dissatisfaction that may arise from unmet expectations.