Abstract
Recovery in osteoarthritis (OA) is a multidimensional construct that extends beyond symptom reduction to encompass how individuals make sense of, adapt to, and live with their condition. Patient expectations appear to play a central role in shaping this process, influencing how individuals define recovery, cope with functional limitations, and evaluate treatment outcomes. Understanding these expectations is essential for improving satisfaction and functional progress in OA management. This scoping review synthesized evidence on patient expectations in knee, hip and generalized OA and examined how these expectations influence treatment outcome and satisfaction. A PRISMA-ScR-informed scoping review was conducted across PubMed, Embase, CINAHL, PsycINFO, and Web of Science up to September 2025. Eligible studies included adults with OA reporting on treatment expectations, expectation fulfillment, or expectations about their ability to cope (self-efficacy). Both qualitative and quantitative designs were included. Data were extracted and organized for study characteristics, population, expectation domains, and outcomes. Sixteen studies met the inclusion criteria, encompassing qualitative syntheses, cohort studies and systematic reviews. Across study designs, higher or fulfilled expectations were consistently associated with greater satisfaction, pain reduction, and functional improvement. Unrealistic or unfulfilled expectations predicted poorer clinical outcomes and dissatisfaction. Expectations surrounding treatment and clinical outcomes may plausibly influence recovery by shaping physiological responses, emotional reactions and patient engagement with rehabilitation. These findings highlight the importance of aligning clinical interventions with patient expectations. Integrating expectation assessment and recalibration into OA care may enhance adherence and patient satisfaction. Future research should further explore expectations as modifiable therapeutic targets and examine how they interact with factors such as symptom duration, severity and pain extension. Such combinations may clarify which patient profiles are most responsive to expectation-focused interventions. Overall, expectations emerge as a central component of recovery and a promising avenue for more person-centered physiotherapy and rehabilitation practice.