Does physiotherapy prehabilitation improve pre-surgical outcomes and influence patient expectations prior to knee and hip joint arthroplasty?

Clode, Nicholas J; Perry, Malcolm O.; Wulff, Lauren

doi:10.1016/j.ijotn.2018.05.004

Cited by 42 publications

(63 citation statements)

References 35 publications

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“…Simple performance measures may identify patients potentially at risk of delayed recovery, providing the opportunity for preoperative medical and functional optimization, and prompt discharge planning (Elings et al 2015, Oosting et al 2016. Prehabilitation has been demonstrated to improve preoperative function (Swank et al 2011, Clode et al 2018) and may successfully be implemented via telerehabilitation (Doiron-Cadrin et al 2019), thereby capturing patients with reduced access (Westby et al 2010), whilst avoiding significant cost burden to both patients and healthcare organizations (Fusco and Turchetti 2016).…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review

et al. 2020

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Background and purpose — Essential for safe and timely hospital discharge, inpatient functional recovery following lower limb arthroplasty is also variable. A previous systematic review reported moderate and conflicting levels of evidence regarding patient-related predictors of inpatient recovery for primary total hip arthroplasty (THA). A systematic review of surgical prognostic factors for inpatient recovery following THA or total knee arthroplasty (TKA) is yet to be undertaken. We identified patient and surgical prognostic factors for inpatient functional recovery following THA and TKA; determined whether inpatient functional recovery varies between these procedures; and established whether validated outcome measures relevant to the patient’s functional requirements for hospital discharge are routinely assessed. Patients and methods — Critical Appraisal Skills Programme checklists assessed methodological quality, and a best-evidence synthesis approach determined the levels of evidence supporting individual prognostic factors. PubMed, CINAHL, Embase, Scopus, and PEDro databases were searched from inception to May 2019. Included studies examined patient or surgical prognostic factors and a validated measure of post-operative function within 2 weeks of primary, unilateral THA or TKA. Results — Comorbidity status and preoperative function are supported by a strong level of evidence for TKA. For THA, no strong level of evidence was found for patient-related prognostic factors, and no surgical factors were independently prognostic for either arthroplasty site. Limited evidence supports fast-track protocols in the TKA population. Interpretation — Preoperative screening and optimization is recommended. Assessment of Enhanced Recovery Pathways using validated outcome measures appropriate for the early postoperative period is warranted.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review

et al. 2020

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“…Patient information plays an important role in patient contentment after surgery. Many studies have shown the positive effects of patient education and information given before surgery [17,18,35,36,44,45]. The importance of information and lack of information was made clear by the discontented participants in our study.…”

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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

Mahdi

Svantesson

Wretenberg

et al. 2020

BMC Musculoskelet Disord

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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.

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“…Quantitative designs have been used to assess patient satisfaction after TKA in previous studies [3, [6][7][8][9][10][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], but to our knowledge no qualitative studies have examined patient´s experience of discontentment after TKA. The few studies addressing patient satisfaction have focused on the importance of patient education and information before and after surgery [23,[32][33][34][35][36][37].…”

Section: Introductionmentioning

confidence: 99%

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

Mahdi

Svantesson

Wretenberg

et al. 2019

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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Does physiotherapy prehabilitation improve pre-surgical outcomes and influence patient expectations prior to knee and hip joint arthroplasty?

Cited by 42 publications

References 35 publications

Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review

Prognostic factors for inpatient functional recovery following total hip and knee arthroplasty: a systematic review

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

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