Patient Expectations of Hip and Knee Joint Replacement Surgery and Postoperative Health Status

Abstract

Objective: To explore the relationship between preoperative patient expectations and postoperative health status in patients undergoing joint replacement surgery, with particular emphasis on the types of expectations held by patients. Methods: Respondents completed the Hospital for Special Surgery (HSS) Hip/Knee Replacement Expectations Questionnaires pre-surgery, in addition to the Western Ontario and McMaster Osteoarthritis Index (WOMAC™) and the Short-Form 36-Item (SF-36) Health Survey and the Arthritis Self-Efficacy Scale. The WOMAC™ Index and SF-36 were also completed 3 and 6 months post-surgery. Results: A total of 106 patients (total hip replacement [THR] = 28; total knee replacement [TKR] = 78) completed questionnaires. No differences were seen in overall expectations between males and females or older or younger patients, although some differences between the age groups were seen for individual expectations on the HSS expectations questionnaires. For THR, a higher rating of the importance of expectations was correlated with a lesser improvement in pain from pre-surgery to 3 months post-surgery, whereas for TKR, a higher rating of expectations was associated with a greater improvement in function to 6 months post-surgery. Conclusions: Patients have high expectations of surgery, which are correlated with post-surgery pain and function. Identifying the broad range of expectations may be helpful in preparation for surgery and gaining greater satisfaction with outcomes.