Outcome Expectations of Total Knee Arthroplasty Patients: The Influence of Demographic Factors, Pain, Personality Traits, Physical and Psychological Status

Unfulfilled preoperative expectations have a strong influence on the outcome after total knee arthroplasty (TKA). More insight into determinants of the level of expectations is useful in identifying patients at risk for having expectations of the treatment result that are too high or too low. This information can be used in optimizing preoperative expectation management. The aim of the current study was to analyze to what extent preoperative outcome expectations of TKA patients are affected by psychological factors, demographic factors, pain, physical function, and general health status. We performed a cross-sectional analysis of 204 patients with symptomatic and radiographic knee osteoarthritis (OA), scheduled for primary TKA. Outcome expectations were measured using the hospital for special surgery knee replacement expectations survey. Independent variables included were age, sex, body mass index, and patient-reported outcome measures for pain, physical function, quality of life, anxiety, depression, catastrophizing, optimism, and pessimism. Multiple linear regression analyses were used to evaluate associations between these variables and preoperative outcome expectations. Female sex, higher age, higher depression score, and duration of complaints > 50 months showed to be significant predictors of lower expectations for the treatment outcome after TKA. Baseline pain and function scores were not related to the level of preoperative expectations. The present study aids in identifying patients at risk for having either too high or too low expectations. This knowledge can be utilized in individualized expectation management interventions

Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

<p>Abstract</p> <p>Objective</p> <p>This systematic review aims to summarise all the available evidence related to the association between pre-operative patient expectations (outcome expectations, process expectations and self efficacy expectations) and 5 different treatment outcomes (overall improvement, pain, function, stiffness and satisfaction) in patients with total knee or total hip arthroplasty at three different follow-op periods (>6 weeks; >6 weeks- ≤6 months; >6 months).</p> <p>Methods</p> <p>English and Dutch language articles were identified through PubMed, EMBASE.com, PsycINFO, CINAHL and The Cochrane Library from inception to September 2012. Articles assessing the association between pre-operative patient expectations and treatment outcomes for TKA/THA in either adjusted or unadjusted analysis were included. Two reviewers, working independently, determined eligibility, rated methodological quality and extracted data on study design, population, expectation measurements, outcome measurements and strength of the associations. Methodological quality was rated by the same reviewers on a 19 item scale. The scores on the quality assessment were taken into account when drawing final conclusions.</p> <p>Results</p> <p>The search strategy generated 2252 unique references, 18 articles met inclusion criteria. Scores on the methodological quality assessment ranged between 6% and 79%. Great variety was seen in definitions and measurement methods of expectations. No significant associations were found between patient expectations and overall improvement, satisfaction and stiffness. Both significant positive and non-significant associations were found for the association between expectations and pain and function.</p> <p>Conclusions</p> <p>There was no consistency in the association between patients’ pre-operative expectations and treatment outcomes for TKA and THA indentified in this systematic review. There exists a need for a sound theoretical framework underlying the construct of ‘patient expectations’ and consistent use of valid measurement instruments to measure that construct in order to facilitate future research synthesis.</p

Patients' pre-operative general and specific outcome expectations predict postoperative pain and function after total knee and total hip arthroplasties

Orthopaedics, Trauma Surgery and Rehabilitatio

The EKSPECT study: The influence of Expectation modification in Knee arthroplasty on Satisfaction of PatiEnts

Background: One out of five patients is unsatisfied to some extent after total knee arthroplasty (TKA). Unmet expectations are the main driver of post-operative dissatisfaction. Improved pre-operative education on realistic expectations for long-term outcome after TKA potentially leads to higher post-operative satisfaction. The effect of expectation modification on post-operative satisfaction in TKA patients has not yet been studied. The primary objective of the presented study is to examine whether an educational module on long-term recovery after TKA will improve patient satisfaction compared to usual pre-operative education. Methods: The EKSPECT study is a randomized controlled trial. Patients with symptomatic and radiographic knee osteoarthritis who are indicated for a pri

Patient sexual function and hip replacement surgery: A survey of surgeon attitudes

Neuro-urology: functional disorders in male and female urogenital trac

Patients' expectations:: determinants, mechanisms and impact on clinical outcomes

promotiedatum: 27-11-2015 � prom-id: 1183

Functional outcome of non-surgical and surgical management for de novo degenerative lumbar scoliosis: a mean follow-up of 10 years

Contains fulltext : 180433.pdf (publisher's version ) (Open Access

Defining a core outcome set for adolescent and young adult patients with a spinal deformity A collaborative effort for the Nordic Spine Surgery Registries

Contains fulltext : 180419.pdf (publisher's version ) (Open Access