Background: The aim of this study was to carry out an in-depth assessment of patient expectations before surgery in a representative sample of the Scottish population undergoing primary total knee arthroplasty and also assess the influence of demographic factors and preoperative functions on expectations.
Methods: This was a prospective cohort study of 200 patients treated in our institution from November 2011 to July 2013. Patients received standard preoperative preparation including consultation with a surgeon, an information booklet and a DVD. Patients completed the Hospital for Special Surgery Knee Replacement Expectation Survey along with the EuroQol EQ-5D-3L health questionnaire on the day of admission.
Results: Fifty-nine percent of the cohort were women, mean age 67.7 years (45-84 years), mean body mass index 32.5 (21-50), mean preoperative Oxford Knee Score 17 (1-44). Relief of pain and improved ability to walk were the most important expectations, followed by the ability to use public transport and/or drive, ability to change position, ability to walk down stairs, and the ability to carry out routine daily activities and/or chores. Some expectations were unrealistic. No relationships between expectations and demographics, including preoperative function, were found.
Conclusion: This study suggests that patients have very high and sometimes unrealistic expectations regarding their improvements after total knee arthroplasty even after detailed preoperative consultation and education. In addition, these expectations cover a wide range of dimensions. We suggest that to effectively manage patients' expectations, it is important to assess each patient individually and reinforce what expectations can realistically be achieved.
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http://dx.doi.org/10.1016/j.arth.2015.10.021 | DOI Listing |
Arch Orthop Trauma Surg
January 2025
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal.
Introduction: Total joint arthroplasties generally achieve good outcomes, but chronic pain and disability are a significant burden after these interventions. Acknowledging relevant risk factors can inform preventive strategies. This study aimed to identify chronic pain profiles 6 months after arthroplasty using the ICD-11 (International Classification of Diseases) classification and to find pre and postsurgical predictors of these profiles.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Department of Orthopaedics, The Royal Infirmary of Edinburgh, Little France, Edinburgh, EH16 4SA, UK.
Introduction: The combined effect of diabetes mellitus and obesity (Diabesity) on total knee replacement (TKR) outcomes is unclear. This study aimed to assess whether diabesity influenced functional outcomes and complication rate following primary TKR.
Materials And Methods: This case-controlled study compared the independent effects of obesity, diabetes, and diabesity on TKR outcomes.
Am J Sports Med
January 2025
Southern California Orthopedic Institute, Van Nuys, California, USA.
Background: Surgical options for septic arthritis include open arthrotomy or an arthroscopic procedure. The optimal surgical technique remains a matter of debate as acceptable results have been reported for both.
Purpose: To evaluate the efficacy of arthroscopy versus arthrotomy for the treatment of septic arthritis in large and intermediate-sized joints.
J Clin Med
January 2025
Department of Orthopedic Surgery, Graduate School of Medicine Sciences, Kanazawa University, 13-1 Takaranachi, Kanazawa 920-8641, Ishikawa, Japan.
This single-center cohort study investigated preoperative risk factors such as physical function, quantity, and quality of the quadriceps femoris for physical activity (PA) 1 year after total knee arthroplasty (TKA). This study included 204 patients with knee osteoarthritis who underwent TKA; they were divided into increased and decreased PA groups. Items with significant differences between the two groups in non-operative-side quadriceps strength, knee injury and osteoarthritis outcome scores (KOOS), Sport/Rec scores, operative-side cross-sectional area (CSA) of the vastus medialis (VM), and operative-side computed tomography attenuation values (CTV) of the vastus lateralis (VL) were fitted in the multiple logistic regression analysis.
View Article and Find Full Text PDFJ Clin Med
January 2025
Orthopedic Surgery Department, Germans Trias i Pujol University Hospital, 08916 Badalona, Spain.
: Chronic pain affects about 20% of total knee arthroplasty (TKA) patients, with high pain catastrophizing being a key predictor. Screening and addressing this modifiable factor may improve postoperative outcomes. : We aimed to compare the effectiveness of two preoperative home-based multimodal physical therapy interventions on pain catastrophizing in high-catastrophizing TKA patients.
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