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It is fascinating for both the patient and the surgeon to predict the outcome of a TKA at an early stage. Satisfaction after TKA is primarily determined by the preoperative expectations of the patient. The purpose of this study was to investigate if the peri-operative expectations of the surgeon predicted the outcome of a TKA.A prospective study of 53 primary TKAs was performed. Preoperatively, the surgeon described the assessment of the difficulty of the TKA on a VAS. Immediately postoperative, the surgeon gave his satisfaction VAS about the procedure. After 1 year the surgeon's satisfaction VAS, the patient's satisfaction VAS and the KSCRS were determined.The Spearman's correlation coefficients between the preoperative difficulty assessment, the immediate postoperative satisfaction and the outcome measurements after 1 year were all very poor (−0.01 to 0.23).The outcome of a TKA depends on multiple factors. Both the surgeon's preoperative assessment of the difficulty and the surgeon's immediate postoperative satisfaction do not independently predict the outcome of a TKA.