{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T15:11:05Z","timestamp":1778339465820,"version":"3.51.4"},"reference-count":0,"publisher":"Pakistan Journal of Medical Sciences","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pak J Med Sci"],"abstract":"<jats:p>Objective: Knee osteoarthritis significantly impacts the quality of life, particularly in advanced stages. Total knee arthroplasty (TKA) is a common treatment, but 20-30% of patients remain dissatisfied despite clinical improvements. This study evaluates TKA outcomes using patient-reported outcome measures (PROMs) in a low-middle-income country context.\nMethodology: A prospective cohort study from Aga Khan University Hospital of 70 patients with end-stage knee osteoarthritis undergoing TKA was conducted from May, 2023 to December, 2023, Improvement in Knee injury and Osteoarthritis Outcome Score (KOOS-42) at three months post-TKA was assessed. The secondary objectives were to evaluate the correlation between patient expectations and outcomes, a comparison of unilateral and bilateral TKA, and the effects of patellar resurfacing and home-based physiotherapy. Data were analyzed using Stata 17.0.\nResults: Significant improvements in KOOS scores were observed three months post-TKA (mean 71.0 \u00b1 7.3, P&lt;0.001) compared to preoperative scores (26.3 [21.6-30]). Patient expectations were higher than actual postoperative outcomes (P&lt;0.001). The pre-operative functional score and Patellar resurfacing improved symptom scores (P=0.003), while other factors like unilateral vs. bilateral TKA and home-based physiotherapy showed no significant impact on overall KOOS scores.\nConclusion: TKA significantly improves patient-reported outcomes, but a gap remains between expectations and actual outcomes. Tailored patient education is crucial to manage expectations and enhance satisfaction, especially in resource-limited settings. These findings support the need for patient-centered care approaches in TKA.\nAbbreviation: TKA: Total Knee Arthroplasty. KOOS: Knee injury and Osteoarthritis Outcome Score. PROMs: Patient-Reported Outcome Measures. KOOS PES: Knee Injury and osteoarthritis (Patient expectations score). LMICs: Low- and Middle-Income Countries. BMI: Body Mass Index. ERC: Ethical Review Committee. GEE: Generalized Estimating Equation. QOL: Quality of Life. OA: Osteoarthritis. HB: Hemoglobin. HCT: Hematocrit.<\/jats:p>","DOI":"10.12669\/pjms.42.3.13328","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T06:04:59Z","timestamp":1773468299000},"page":"653-659","source":"Crossref","is-referenced-by-count":0,"title":["Total knee Arthroplasty: Patient expectations and outcomes in a resource constrained setting"],"prefix":"10.12669","volume":"42","author":[{"given":"Muhammad Ahmed Ghazni","family":"Khan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Ahsan","family":"Sulaiman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Mohammad Motiwala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Shahryar Noordin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4935","published-online":{"date-parts":[[2026,3,5]]},"container-title":["Pakistan Journal of Medical Sciences"],"original-title":[],"link":[{"URL":"https:\/\/pjms.org.pk\/index.php\/pjms\/article\/download\/13328\/3267","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/pjms.org.pk\/index.php\/pjms\/article\/download\/13328\/3267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T14:47:13Z","timestamp":1778338033000},"score":1,"resource":{"primary":{"URL":"https:\/\/pjms.org.pk\/index.php\/pjms\/article\/view\/13328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,5]]}},"URL":"https:\/\/doi.org\/10.12669\/pjms.42.3.13328","relation":{},"ISSN":["1681-715X","1682-024X"],"issn-type":[{"value":"1681-715X","type":"electronic"},{"value":"1682-024X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,5]]}}}