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Patients control preferences and results in knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Patient engagement in a patient–physician decision-making process has been correlated with satisfaction and clinical outcomes. Aim of this study is to evaluate if patient control preference may also influence TKA results.

Methods

One hundred and seventy-six patients (120w–56m, age 66 ± 9 years, BMI 28 ± 4) underwent TKA and were prospectively evaluated, before surgery and at 6 and 12 months. The preoperative assessment included the Control Preference Scale (CPS) and other scales measuring psychological aspects (STAI, BDI, TSK), as well as SF12 (physical and mental subscales) and the assessment of pain and function. Pain, function, and SF12 subscales were then used to evaluate the improvement at 6- and 12-month follow-up.

Results

Pain, function, and SF12 scores improved at 6 and 12 months. CPS correlated with the outcome: pain and functional improvement at 6 months (p = 0.014; p = 0.003, respectively), patient function at 6 months (p = 0.022), improvement of SF12 physical subscale at 6 and 12 months (p = 0.027; p = 0.037, respectively), and satisfaction at 6 months (p = 0.033). Moreover, the multivariate analysis confirmed the importance of CPS regardless of other demographic, physical or psychological characteristics.

Conclusion

In contrast with previous literature findings, this study shows that patients with more propensity for control presented lower improvements of pain and function than those more prone to rely on the physician making the decision. Physicians should be aware that the patient control preference may influence the treatment outcome and undertake measurements to optimize patient participation in the shared process to optimize the chances of TKA success.

Level of evidence

IV.

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Acknowledgements

The authors thank Elettra Pignotti for the assistance in the statistical analysis and Lucia Mancini for English editing.

Author information

Authors and Affiliations

  1. Laboratory of NanoBiotechnology (NABI), Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, Bologna, Italy

    G. Filardo, A. Roffi, G. Merli & E. Kon

  2. Mood, Centro per lo studio e la cura dei disturbi emotivi, Bologna, Italy

    T. Marcacci, F. Berti Ceroni & D. Raboni

  3. I Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Pupilli 1, Bologna, Italy

    M. Marcacci

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  1. G. Filardo
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  2. A. Roffi
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  3. G. Merli
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  4. T. Marcacci
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  5. F. Berti Ceroni
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  6. D. Raboni
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  7. E. Kon
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  8. M. Marcacci
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Corresponding author

Correspondence to A. Roffi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No funding was obtained for the work associated with this study.

Ethical approval

The study was approved by the local Ethics Committee.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Filardo, G., Roffi, A., Merli, G. et al. Patients control preferences and results in knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25, 552–558 (2017). https://doi.org/10.1007/s00167-016-4405-6

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  • DOI: https://doi.org/10.1007/s00167-016-4405-6

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