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A review of patient s expectations and outcome following total knee arthroplasty

Authors: Vamsi Kondreddi , Sankara Rao Pinnamaneni , Ranjith K Yalamanchili
Int J Biol Med Res. 2016; 7(1): 5367-5369  |  PDF File


Patients expectations are variably reported to influence functional outcome and satisfaction after total knee arthroplasty. 154 patients with osteoarthritis of the knee were subjected to a questionnaire on their expectations of surgery in terms of expected time of recovery, expected pain after recovery, and expected limitations in everyday activities. Post operatively patients were followed to evaluate outcome both clinically and functionally using knee society clinical and functional scoring system. Correlation of pre operative expectations to post operative outcome was assessed and parameters of expectation analysed. Patients significantly underestimated the time for full recovery (expected 1.2 ± 0.6 months, recalled actual time is 2.7 ± 0.7 months; P = 0.005). They were also overly optimistic about the likelihood of being painfree (98% expected it, 63% were; P < 0.005) and of not being limited in usual activities (82% expected it, 59% were; P < 0.005). The overall satisfaction post operatively at 1 year follow up was 61% as evaluated in terms of variants – pain, recovery, limiting activities. Pre operative expectations met the satisfactory levels at follow up in Hi Flex designs (69%) as to only 52.8% in others. Pre operative expectations did not meet the satisfactory levels in cases of Rhumatoid arthritis. The impact of patient expectations on satisfaction is profound. It would be better for orthopaedic surgeons and patients to discuss expectations before the surgery to assure that these are realistic.