A prospective study of the association of patient expectations with changes in health-related quality of life outcomes, following total joint replacement

Abstract

BackgroundPatient expectations regarding surgery may be related to outcomes in total joint replacement (TJR). The aim of this study was to determine the association of patient expectations with health related quality of life (HRQoL) outcomes measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 12 (SF-12) and satisfaction with current symptoms measured on a 4-point Likert scale, one year after surgery, adjusting for Body Mass Index (BMI), age, gender, joint, education, previous intervention and baseline scores.MethodsConsecutive patients preparing for TJR of the knee or hip due to primary osteoarthritis (OA) in 15 hospitals in Spain were recruited for the study. Patients completed questionnaires before surgery and 12 months afterwards: five questions about expectations before surgery; an item to measure satisfaction; two HRQoL instruments—WOMAC and SF-12; as well as questions about sociodemographic information. To determine the association of patient expectations at baseline, with changes in HRQoL 12 months after surgery and with satisfaction, general linear models and logistic regression analysis were performed.ResultsA total of 892 patients took part in the study. Patients who had higher pain relief or ability to walk expectations improved more in HRQoL at 12 months. Moreover, patients with high daily activity expectations were more satisfied.ConclusionsPatients with higher baseline expectations for TJR, improved more in HRQoL at one year and had more likelihood to be satisfied than patients with lower expectations, adjusted for BMI, age, gender, joint, education, previous intervention and HRQoL baseline scores.

The Virtue of Optimistic Realism- Expectation Fulfillment Predicts Patient-Rated Global Effectiveness of Total Hip Arthroplasty

“…We lost 8% of the study cohort to follow-up for unknown reasons. Compared to other prospective cohort studies, the drop-out rate in our case was rather low [20]. Still, we cannot exclude the risk of attrition bias due to a selective drop-out of nonresponders which would lead to a slight overestimation of outcome evaluations and global effectiveness ratings.…”

“…The willingness to return to an institution for postoperative monitoring or other surgical procedures strongly depends on the patients' evaluation of treatment effectiveness and their satisfaction with postoperative outcomes [19,20]. Important technical progress has already been made in the area of THA which reduces the chances of future major breakthroughs in this eld [21].…”

“How Much Does My Implant Weigh?”: Addressing Patient Concern about Weight Gain after Total Hip Arthroplasty

“…It has been found that there is an association between patient expectations and outcomes after TJA. 11,12 The expectation of complete pain relief and the expectation of a low risk of complications were independent predictors postoperatively of better physical function, pain improvement, and patient satisfaction following TJA. 11 Ultimately, they determine that patient expectations are independent predictors of improved functional outcomes and satisfaction postoperatively after TJA.…”

“…Gonzalez Saenz de Tejada et al evaluated the association between patient expectations with health-related quality of life outcomes (HRQoL) as measured by The Western Ontario and McMaster Universities Osteoarthritis Index and Short-Form 12 and satisfaction with current symptoms. 12 It was determined that patients with higher expectations were more likely to be satisfied postoperatively and had greater improvements in HRQoL. Knowing this information, we can play a pivotal role as surgeons by emphasizing the positive outcomes from TJA.…”

Peculiarities of the psychological state of patients in pre- and postoperative period of arthroplasty of large joints

“…Испанские исследователи проанализировали у 892 пациентов взаимосвязи ожиданий от операции по замене сустава и качество жизни через год после операции. Полученные результаты показали, что у пациентов, имеющих более высокие начальные ожидания относительно операции, выявлена большая вероятность улучшения качества жизни и двигательной активности по сравнению с пациентами, имеющими изначально более низкие ожидания от оперативного вмешательства [8].…”