Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties

Abstract

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.

Figures

Fig. 1

A flow diagram shows the patients in the THA trial.

Fig. 2

A flow diagram shows the patients in the TKA trial.