Clinical evidence of traditional vs fast track recovery methodologies after total arthroplasty for osteoarthritic knee treatment. A retrospective observational study

Castorina, Sergio; Guglielmino, Claudia; Castrogiovanni, Paola; Szychlinska, Marta Anna; Ioppolo, F.; Massimino, P.; Leonardi, P.; Maci, C.; Iannuzzi, M.; Giunta, A. Di; Musumeci, Giuseppe

doi:10.32098/mltj.03.2017.14

“…A recent study showed that an improvement of five degrees in the range of motion in the knee after surgery along with an improved walking distance could increase the satisfaction rate by 6-8 times [49]. Other studies also agree with the effect of stiffness on satisfaction [50,51]. In the current study the patients' course of recovery was not investigated, only if there were complications or not.…”

Section: Discussionsupporting

confidence: 52%

Patients’ experiences of discontentment one year after total knee arthroplasty- A qualitative study

Mahdi

¹

,

Svantesson

²

,

Wretenberg

³

et al. 2020

Preprint

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Background Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are discontented without known explanation. Contentment and discontentment have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients’ experiences. Qualitative knowledge might be useful in creating strategies to decrease the discontentment rate. Methods Of the 348 patients who responded to a letter asking if they were contented or discontented with their surgery, 61 (18%) reported discontentment. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients’ experiences of discontentment one year after total knee arthroplasty. Results The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and need for buttresses. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a need for buttresses, and a lack of respect and continuity, support from health care, and information adapted to their needs. Conclusion Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient contentment after surgery.

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“…They had not been sufficiently informed and prepared regarding this preoperatively. However, many studies have shown that "fast track" TKA procedures, with discharge on the day of surgery or the day after, are associated with good satisfaction rates [45][46][47]. We did not differentiate between fast track and conventional surgeries, so we cannot say if our results regarding the percentage of discontentment differ from these other study populations.…”

Section: Discussionmentioning

confidence: 81%

Why are patients discontented after total knee arthroplasty when the orthopedic surgeons are contented?

Mahdi

¹

,

Svantesson

²

,

Wretenberg

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are discontented without known explanation. Contentment and discontentment have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients’ experiences. Qualitative knowledge might be useful in creating strategies to decrease the discontentment rate. Methods Of the 348 patients who responded to a letter asking if they were contented or discontented with their surgery, 61 (18%) reported discontentment. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients’ experiences of discontentment one year after total knee arthroplasty. Results The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and need for buttresses. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a need for buttresses, and a lack of respect and continuity, support from health care, and information adapted to their needs. Conclusion Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient contentment after surgery.

show abstract

“…They had not been sufficiently informed and prepared regarding this preoperatively. However, many studies have shown that "fast track" TKA procedures, with discharge on the day of surgery or the day after, are associated with good satisfaction rates [52][53][54]. We did not differentiate between fast track and conventional surgeries, so we cannot say if our results regarding the percentage of dissatisfaction differ from these other study populations.…”

Section: Discussionmentioning

confidence: 82%

Patients’ experiences of discontentment one year after total knee arthroplasty- a qualitative study

Mahdi

¹

,

Svantesson

²

,

Wretenberg

³

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: Total knee arthroplasty is a common procedure with generally good results. However, there are still patients who are dissatisfied without known explanation. Satisfaction and dissatisfaction have previously been captured by quantitative designs, but there is a lack of qualitative studies regarding these patients' experiences. Qualitative knowledge might be useful in creating strategies to decrease the dissatisfaction rate. Methods: Of the 348 patients who responded to a letter asking if they were satisfied or dissatisfied with their surgery, 61 (18%) reported discontent. After excluding patients with documented complications and those who declined to participate, semi-structured interviews were conducted with 44 patients. The interviews were analyzed according to qualitative content analysis. The purpose was to describe patients' experiences of discontentment 1 year after total knee arthroplasty. Results: The patients experienced unfulfilled expectations and needs regarding unresolved and new problems, limited independence, and lacking of relational supports. They were bothered by pain and stiffness, and worried that changes were complications as a result of surgery. They described inability to perform daily activities and valued activities. They also felt a lack of relational supports, and a lack of respect and continuity, support from health care, and information adapted to their needs. Conclusion: Patient expectation seems to be the major contributing factor in patient discontentment after knee replacement surgery. This qualitative study sheds light on the on the meaning of unfulfilled expectations, in contrast to previous quantitative studies. The elements of unfulfilled expectations need to be dealt with both on the individual staff level and on the organizational level. For instance, increased continuity of healthcare staff and facilities may help to improve patient satisfaction after surgery.

show abstract

Clinical evidence of traditional vs fast track recovery methodologies after total arthroplasty for osteoarthritic knee treatment. A retrospective observational study

Cited by 36 publications

References 21 publications

Patients’ experiences of discontentment one year after total knee arthroplasty- A qualitative study

Patients’ experiences of discontentment one year after total knee arthroplasty- A qualitative study

Why are patients discontented after total knee arthroplasty when the orthopedic surgeons are contented?

Patients’ experiences of discontentment one year after total knee arthroplasty- a qualitative study

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