HSS Journal

, 7:229

How Often are Patient and Surgeon Recovery Expectations for Total Joint Arthroplasty Aligned? Results of a Pilot Study

  • Hassan M. K. Ghomrawi
  • Nuria Franco Ferrando
  • Lisa A. Mandl
  • Huong Do
  • Neaz Noor
  • Alejandro Gonzalez Della Valle
Original Article

DOI: 10.1007/s11420-011-9203-6

Cite this article as:
Ghomrawi, H.M.K., Franco Ferrando, N., Mandl, L.A. et al. HSS Jrnl (2011) 7: 229. doi:10.1007/s11420-011-9203-6

Abstract

Background

Surgeons strive to set patient expectations for recovery following total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, some patients report dissatisfaction after surgery due to unmet expectations.

Purpose

We compared patients’ and surgeon’s recovery expectations prior to primary THA and TKA.

Methods

Sixty eight patients scheduled to undergo primary total hip replacement (THR) or total knee replacement (TKR) surgery were enrolled. Before surgery, patients filled out a validated recovery expectations questionnaire that quantified expectations of postoperative pain relief, function, and well-being with a value from 0 to 100 (higher being more optimistic). The surgeon independently completed the same questionnaire for each patient. Overall score and item-specific comparisons were conducted. Correlations were explored between agreement level, demographics, patient-reported health status measures, and patients’ assessments of the risk of complications associated with surgery.

Results

Most patients undergoing THR or TKR had higher expectations for recovery than their surgeon. Applying the clinically meaningful difference in expectations (≥7 points), 52.5% of the TKA patients’ expectations exceeded those of the surgeon, while 22.5% expected less than their surgeon and 60.7% of THA patients’ expectations exceeded those of the surgeon, while 21.4% expected less than their surgeon. THA patients with either lower or higher expectations than their surgeon had lower physical and mental health status scores. TKA patients with lower expectations compared to their surgeon had a higher expectation of complications.

Conclusions

More than 50% of the patients had higher expectations than their surgeon and this was driven by expectations of high-level activities and extreme range of motion. Further investigations are needed to understand these differences so as to enhance patient preoperative education.

Keywords

total hip replacementtotal knee replacementpreoperative expectationsdiscordance

Copyright information

© Hospital for Special Surgery 2011

Authors and Affiliations

  • Hassan M. K. Ghomrawi
    • 1
    • 4
  • Nuria Franco Ferrando
    • 2
  • Lisa A. Mandl
    • 3
  • Huong Do
    • 4
  • Neaz Noor
    • 1
  • Alejandro Gonzalez Della Valle
    • 5
  1. 1.Division of Health Policy Department of Public HealthWeill Cornell Medical CollegeNew YorkUSA
  2. 2.Department of OrthopaedicsHospital Universitario La FeValenciaSpain
  3. 3.Department of RheumatologyHospital for Special SurgeryNew YorkUSA
  4. 4.Epidemiology and Biostatistics CoreHospital for Special SurgeryNew YorkUSA
  5. 5.Department of Orthopedic SurgeryHospital for Special SurgeryNew YorkUSA