Clinical Orthopaedics and Related Research: February 2008 - Volume 466 - Issue 2 - p 424-431 doi: 10.1007/s11999-007-0052-z

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

Mancuso, Carol, A.1,a; Graziano, Suzanne2; Briskie, Lisa, M.2; Peterson, Margaret, G. E.3; Pellicci, Paul, M.4; Salvati, Eduardo, A.4; Sculco, Thomas, P.4
Hip Knee

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.

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