Page 69 - The value of total hip and knee arthroplasties for patients

Unfulfilled expectations after total hip and knee arthroplasty surgery: there’s a need for better preoperative patient information and education
Implications
The observation from the present and previous studies that for some specific
outcomes of THA or TKA, relatively large proportions of patients have unfulfilled
expectations may have implications for the preoperative management.These findings
underscore a need for patient education focused on realistic expectations specifically
for those items (eg, walking stairs, cutting toenails, walking ability, kneeling down
and squatting) that were found to be unfulfilled in many patients. Discussing these
patient’s expectations preoperatively may support patient-clinician communication,
shared decision making, and might influence postoperative outcome as well. 4
Furthermore, to our knowledge, our study is the first that assessed whether and more specifically which expectations were exceeded for THA and TKA. In addition, in other medical fields, little attention has been given to this phenomenon. Investigating the role of exceeded expectations in outcomes such as satisfaction and general perceived effect on a postposed treatment (weather surgical or conservative) may bring us 1 step closer to resolving the debate on what the most optimal expectation is, high or low expectations that may be easily exceeded.
In conclusion, this study shows that THA and TKA patients have high expectations for different aspects of outcome of surgery. For THA patients, most of these expectations are met or even exceeded.
Specifically, in the pain-related domains and the “simple” function-related items,THAs are fulfilling patients’ expectations. However, for TKA, expectations regarding daily activities and sports and recreation functions were less often fulfilled.The results of this study are relevant for preoperative patients’ education. It would be of value to pay more attention to patients’ expectations and setting realistic goals and aims.
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