Patient Satisfaction With Perioperative Services and Associated Factors in Ethiopia: Systematic Review and Meta-Analysis.

With the global aging population on the rise, the number of individuals aged 60 and above is steadily growing. Osteoarthritis (OA) of the knee represents a significant burden of disease, with projections indicating a 75% increase from 2020 to 2050 [, ]. The growing prevalence of OA and rheumatoid arthritis among the elderly has led to a marked increase in the demand for effective treatments and healthcare services, placing additional strain on healthcare systems worldwide [, ]. This surge reflects the rising need for surgical intervention to manage joint deterioration in this aging population. Total knee arthroplasty (TKA), which is performed more than 1.5 million times annually according to data from ten national joint registries, continues to see rapid growth in the number of surgeries each year []. In China, the average hospitalization cost for TKA is approximately 61,208.3 RMB per patient []. While patient satisfaction following TKA has significantly improved, reaching up to 91% [, ], there is growing evidence that healthcare management systems—including Medicare, Medicaid, and private insurance providers—are increasingly adopting PROMs as a tool to evaluate and determine patient eligibility for TKA []. This shift reflects a broader trend towards incorporating patient-centered metrics into clinical decision-making processes. The use of PROMs in assessing patients undergoing TKA has been steadily increasing [, ]. PROMs are frequently used in areas such as HRQoL to assess the success rate of joint replacement surgeries and postoperative satisfaction [, ]. The EQ-5D-5L is a brief, generic questionnaire designed to improve sensitivity and reduce the ceiling effect seen in earlier versions of the EQ-5D. Its main advantage lies in its ability to generate health utility values, which are crucial for calculating quality-adjusted life years in health economics and for conducting cost-effectiveness analyses [, ]. The EQ-5D-5L is frequently utilized in cost-effectiveness analysis, providing valuable information on changes in health status before and after TKA [, ]. The MCID reflects a noticeable improvement in their condition or quality of life []. However, the specific threshold for the MCID in the EQ-5D-5L score for patients undergoing TKA has yet to be determined. The lack of a clearly defined MCID for the EQ-5D-5L in patients undergoing TKA hinders the accurate evaluation and enhancement of HRQoL post-surgery. Without this threshold, it becomes challenging to determine the smallest change that signifies a meaningful improvement in both knee function and overall patient well-being. Therefore, determining the MCID for the EQ-5D-5L in TKA patients is essential. This study seeks to establish the smallest change in the EQ-5D-5L score that patients perceive as beneficial in the context of primary TKA.