Conclusions
Dispositional optimism is positively associated with pre-operative joint function and, more importantly, post-operative functional outcome in TKA, whereas the opposite applies for pessimism. Assessing patients’ general personality traits prior to surgery to identify pessimistic patients, hence being at risk for poor outcome in TKA, should be considered to react to the patients’ special needs and possible pessimistic expectations, i.e., through a cognitive–behavioral intervention, to potentially increase optimism and hereby post-operative outcome in TKA.