, Volume 466, Issue 2, pp 424-431
Date: 10 Jan 2008

Randomized Trials to Modify Patients’ Preoperative Expectations of Hip and Knee Arthroplasties

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Patients have multiple expectations of THA and TKA. We asked whether preoperative educational classes addressing recovery during the first year could modify patients’ expectations of their 12-month postoperative recovery. Participants were enrolled consecutively in two randomized, controlled trials, one for THA (177 patients) and one for TKA (143 patients). Control patients preoperatively received a standard THA or TKA class addressing recovery immediately after surgery. Intervention patients preoperatively received the standard class plus a joint-specific module addressing recovery during the first 12 months. Before and after the class, patients completed either a hip-specific or knee-specific validated expectations survey. The main outcome was the within-patient change in expectation scores (maximum increase, +100; maximum decrease, −100) before and after the class but preoperatively. Mean changes in hip scores were +3.3 ± 8 for intervention patients (range, −22–+32) and +4.9 ± 8 for control patients (range, −13–+29). Mean changes in knee scores were −3.4 ± 10 for intervention patients (range, −26–+33) and +2.4 ± 10 for control patients (range, −30–+30). Patients’ preoperative expectations of their recovery from THA or TKA can be modified by preoperative educational classes.

Level of Evidence: Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

One or more of the authors (CAM) have received funding from the Department of Orthopedic Surgery, Hospital for Special Surgery, and the Center for Aging Research and Clinical Care, Division of Geriatrics and Gerontology, Joan and Sanford I. Weill Medical College of Cornell University through NIA AG00853.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.
The Corresponding Author confirms all seven authors were required to design this trial.