Clinical Orthopaedics and Related Research

, Volume 466, Issue 2, pp 424–431 | Cite as

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

  • Carol A. MancusoEmail author
  • Suzanne Graziano
  • Lisa M. Briskie
  • Margaret G. E. Peterson
  • Paul M. Pellicci
  • Eduardo A. Salvati
  • Thomas P. Sculco
Original Article


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.


Control Patient Randomization Group Nurse Educator Educational Module Standard Class 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Steven B. Haas, MD, Russell E. Windsor, MD, Lobel Lurie, RN, and Jeanmarie Ginty-Zusi, RN, for their participation.


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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Carol A. Mancuso
    • 1
    Email author
  • Suzanne Graziano
    • 2
  • Lisa M. Briskie
    • 2
  • Margaret G. E. Peterson
    • 3
  • Paul M. Pellicci
    • 4
  • Eduardo A. Salvati
    • 4
  • Thomas P. Sculco
    • 4
  1. 1.Department of MedicineHospital for Special SurgeryNew YorkUSA
  2. 2.Department of NursingHospital for Special SurgeryNew YorkUSA
  3. 3.Research DivisionHospital for Special SurgeryNew YorkUSA
  4. 4.Department of Orthopedic SurgeryHospital for Special SurgeryNew YorkUSA

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