Skip to main content

Advertisement

SpringerLink
Log in

A new methodology for patient education in total knee arthroplasty: a randomized controlled trial

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

We established a method in which patients are instructed before total knee arthroplasty (TKA) in a differentiated way without the necessity of reading any self-orientation, which can be applied even for illiterate patients

Methods

We developed a multidisciplinary approach to improve patient education in TKA comprising of a differentiated orientation conducted by an orthopedic surgeon, a nurse and a physiotherapist. It consists of standardized lectures regarding on pre-, intra- and postoperative issues in a randomized controlled trial of 79 consecutive patients undergoing primary TKA. Thirty-four patients received the standard education (control group), and 45 patients received the differentiated education (intervention group). The patients were evaluated during at least 6 months.

Results

After a 6-month follow-up period, the Short Form Health Survey (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analogue pain scale (VAS) and knee range of motion (ROM) improved significantly in both groups. Range of motion was better in the intervention group (mean and SD—106.9 ± 5.7 versus 92.5 ± 12.1 degrees, p = 0.02). Moreover, walk ability (more than 400 m) was better in the intervention group compared with the control group (97.4% versus 72.4%, p = 0.003). In the intervention and control groups, respectively, 10.5% and 31% of patients reported the need for some walking devices (p = 0.03).

Conclusions

A differentiated educational program with a multidisciplinary team had a positive impact on functional outcomes, improving ROM and walk ability of patients undergoing TKA in a short-term evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of data and materials

The authors have full access to all dataset in the study and assume final responsibility for the publication. The data used and analyzed during the current study are available through the corresponding author upon reasonable request. The authors have copyright permission for Figs. 1 and 2.

Abbreviations

TKA:

Total knee arthroplasty

SF-36:

Medical Study 36-item Short-Form Health Survey

WOMAC:

Western Ontario and McMaster Universities Osteoarthritis Index

ROM:

Range of motion

OA:

Osteoarthritis

VAS:

Visual analog scale

References

  1. Buckwalter JA (1995) Osteoarthritis and articular cartilage use, disuse, and abuse: experimental studies. J Rheumatol Suppl 43:13–15

    CAS  PubMed  Google Scholar 

  2. Neogi T, Zhang Y (2013) Epidemiology of osteoarthritis. Rheum Dis Clin North Am 39(1):1–19

    Article  Google Scholar 

  3. Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G et al (2008) Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum 59(9):1207–1213

    Article  Google Scholar 

  4. Arden N, Nevitt MC (2006) Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol 20(1):3–25

    Article  Google Scholar 

  5. Senna ER, De Barros AL, Silva EO, Costa IF, Pereira LV, Ciconelli RM et al (2004) Prevalence of rheumatic diseases in Brazil: a study using the COPCORD approach. J Rheumatol 31(3):594–597

    PubMed  Google Scholar 

  6. Utrillas-Compaired A, De la Torre-Escuredo BJ, Tebar-Martínez AJ, Asúnsolo-Del BÁ (2014) Does preoperative psychologic distress influence pain, function, and quality of life after TKA? Clin Orthop Relat Res 472(8):2457–2465

    Article  Google Scholar 

  7. Pagnano MW, McLamb LA, Trousdale RT (2004) Total knee arthroplasty for patients 90 years of age and older. Clin Orthop Relat Res 418:179–183

    Article  Google Scholar 

  8. Ethgen O, Bruyère O, Richy F, Dardennes C, Reginster JY (2004) Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 86(A5):963–974

    Article  Google Scholar 

  9. Shan L, Shan B, Suzuki A, Nouh F, Saxena A (2015) Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am 97(2):156–168

    Article  Google Scholar 

  10. Louw A, Diener I, Butler DS, Puentedura EJ (2013) Preoperative education addressing postoperative pain in total joint arthroplasty: review of content and educational delivery methods. Physiother Theory Pract 29(3):175–194

    Article  Google Scholar 

  11. McDonald S, Page MJ, Beringer K, Wasiak J, Sprowson A (2014) Preoperative education for hip or knee replacement. Cochrane Database Syst Rev. 5:CD 003526

    Google Scholar 

  12. Sanz-Ruiz P, Carbo-Laso E, Alonso-Polo B, Matas-Diez JA, Vaquero-Martín J (2016) Does a new implant design with more physiological kinematics provide better results after knee arthroplasty? Knee 23:399–405

    Article  Google Scholar 

  13. Noble PC, Conditt MA, Cook KF, Mathis KB (2006) The John Insall Award: Patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 452:35–43

    Article  Google Scholar 

  14. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD (2010) Patient satisfaction after total knee arthroplasty: Who is satisfied and who is not? Clin Orthop Relat Res 468(1):57–63

    Article  Google Scholar 

  15. Ritter MA, Lutgring JD, Davis KE, Berend ME (2008) The effect of postoperative range of motion on functional activities after posterior cruciate-retaining total knee arthroplasty. J Bone Joint Surg Am 90(4):777–784

    Article  Google Scholar 

  16. Laubenthal KN, Smidt GL, Kettelkamp DB (1972) A quantitative analysis of knee motion during activities of daily living. Phys Ther 52(1):34–43

    Article  CAS  Google Scholar 

  17. Kotani A, Yonekura A, Bourne RB (2005) Factors influencing range of motion after contemporary total knee arthroplasty. J Arthroplasty 20(7):850–856

    Article  Google Scholar 

  18. Gocen Z, Sen A, Unver B, Karatosun V, Gunal I (2004) The effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial. Clin Rehabil 18(4):353–358

    Article  Google Scholar 

  19. Vukomanović A, Popović Z, Durović A, Krstić L (2008) The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty. Vojnosanit Pregl 65(4):291–297

    Article  Google Scholar 

  20. Abu Al-Rub Z, Hussaini M, Gerrand CH (2014) What do patients know about their joint replacement implants? Scott Med J 59(3):158–161

    Article  Google Scholar 

  21. Demir F, Ozsaker E, Ilce AO (2008) The quality and suitability of written educational materials for patients*. J Clin Nurs 17(2):259–265

    Article  Google Scholar 

  22. Ayers DC, Franklin PD, Trief PM, Ploutz-Snyder R, Freund D (2004) Psychological attributes of preoperative total joint replacement patients: implications for optimal physical outcome. J Arthroplasty 19(7 Suppl 2):125–130

    Article  Google Scholar 

  23. Nilsdotter AK, Toksvig-Larsen S, Roos EM (2009) A 5 year prospective study of patient-relevant outcomes after total knee replacement. Osteoarthritis Cartilage 17(5):601–606

    Article  Google Scholar 

  24. Papakostidou I, Dailiana ZH, Papapolychroniou T, Liaropoulos L, Zintzaras E, Karachalios TS et al (2012) Factors affecting the quality of life after total knee arthroplasties: a prospective study. BMC Musculoskelet Disord 13:116

    Article  Google Scholar 

  25. Fitzgerald JD, Orav EJ, Lee TH, Marcantonio ER, Poss R, Goldman L et al (2004) Patient quality of life during the 12 months following joint replacement surgery. Arthritis Rheum 51(1):100–109

    Article  Google Scholar 

Download references

Acknowledgements

No further acknowledgements.

Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Marco Antonio Percope de Andrade, Guilherme Moreira de Abreu Silva, Tulio Vinicius de Oliveira Campos, David Guen Kasuya Barbosa, Danilo da Silva Leite, Marcus Vinicius Teodoro Rezende, Felipe Maciel Santos & Tauam Filipe Galo Magalhaes

Authors
  1. Marco Antonio Percope de Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guilherme Moreira de Abreu Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tulio Vinicius de Oliveira Campos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David Guen Kasuya Barbosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Danilo da Silva Leite
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marcus Vinicius Teodoro Rezende
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Felipe Maciel Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tauam Filipe Galo Magalhaes
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MAPA conceptualized the study and design. DGKB, DSL, MVTR, TFGM and FSM recruited the participants and collected the data. MAPA, GMAS and TVOC prepared the first draft of the manuscript and all authors contributed to writing, as well as review and approval of the final version of the manuscript.

Corresponding author

Correspondence to Marco Antonio Percope de Andrade.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest regarding this research.

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments. The consent obtained from study participants was written and approved by the Ethics Committee. An institutional review board approval from the Ethics Committee of the Universidade Federal de Minas Gerais was obtained for our research protocol to prospective data acquisition of 39 (79)  patients undergoing TKA (CAAE:11677714.4.0000.5149), and an informed consent was signed by all the participants or one person responsible for them.

Consent for publication

Not Applicable.

Competing interests

Authors declare that they do not have any financial and non-financial competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Percope de Andrade, M.A., Moreira de Abreu Silva, G., de Oliveira Campos, T.V. et al. A new methodology for patient education in total knee arthroplasty: a randomized controlled trial. Eur J Orthop Surg Traumatol 32, 107–112 (2022). https://doi.org/10.1007/s00590-021-02936-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-021-02936-y

Keywords

Search

Navigation