Experiences of pre- and postoperative information among patients undergoing knee arthroplasty: a systematic review and narrative synthesis

Buus, Amanda Agnes Østervig; Hejlsen, Ole Kristian; Bjørnes, Charlotte D.; Laugesen, Britt

doi:10.1080/09638288.2019.1615997

Cited by 23 publications

(28 citation statements)

References 85 publications

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“…The large number of education topics included in the final recommendations corresponds with qualitative literature highlighting the importance of comprehensive pre-operative TKR education [15,17]. This study's findings also support and expand those of previous Delphi studies [29][30][31][32][33].…”

Section: Discussionsupporting

confidence: 81%

“…Optimising pre-operative TKR care is an important strategy for addressing the above issues [14][15][16]. For example, pre-operative TKR education helps set realistic expectations [14,17] and may reduce pre-operative anxiety [14] and length of hospital stay [18]. Systematic reviews suggest that pre-operative TKR exercise also shortens length of hospital stay and improves postoperative outcomes [16,19].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study

Anderson

Comer

Smith

et al. 2021

BMC Musculoskelet Disord

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Background Over 90,000 total knee replacement (TKR) procedures are performed annually in the United Kingdom (UK). Patients awaiting TKR face long delays whilst enduring severe pain and functional limitations. Almost 20% of patients who undergo TKR are not satisfied post-operatively. Optimising pre-operative TKR education and prehabilitation could help improve patient outcomes pre- and post-operatively; however, current pre-operative TKR care varies widely. Definitive evidence on the optimal content and delivery of pre-operative TKR care is lacking. This study aimed to develop evidence- and consensus-based recommendations on pre-operative TKR education and prehabilitation. Methods A UK-based, three-round, online modified Delphi study was conducted with a 60-member expert panel. All panellists had experience of TKR services as patients (n = 30) or professionals (n = 30). Round 1 included initial recommendations developed from a mixed methods rapid review. Panellists rated the importance of each item on a five-point Likert scale. Panellists could also suggest additional items in Round 1. Rounds 2 and 3 included all items from Round 1, new items suggested in Round 1 and charts summarising panellists’ importance ratings from the preceding round. Free-text responses were analysed using content analysis. Quantitative data were analysed descriptively. All items rated as ‘Important’ or ‘Very important’ by at least 70% of all respondents in Round 3 were included in the final set of recommendations. Results Fifty-five panellists (92%) (patients n = 26; professionals n = 29) completed Round 3. Eighty-six recommendation items were included in Round 1. Fifteen new items were added in Round 2. Rounds 2 and 3 therefore included 101 items. Seventy-seven of these reached consensus in Round 3. Six items reached consensus amongst patient or professional panellists only in Round 3. The final set of recommendations comprises 34 education topics, 18 education delivery approaches, 10 exercise types, 13 exercise delivery approaches and two other treatments. Conclusions This modified Delphi study developed a comprehensive set of recommendations that represent a useful resource for guiding decision-making on the content and delivery of pre-operative TKR education and prehabilitation. The recommendations will need to be interpreted and reviewed periodically in light of emerging evidence.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study

Anderson

Comer

Smith

et al. 2021

BMC Musculoskelet Disord

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“…First, all individuals who are going to have or have had total knee arthroplasty should have access to a resource person who can provide information on both the implant and return to work to reduce fears and their negative repercussions. This implication is substantiated by the Buus et al 49 study. In addition, orthopedists involved in the evaluation process should be made aware of the demands of the workers’ pre-intervention jobs.…”

Section: Discussionmentioning

confidence: 59%

Return to work following total knee arthroplasty: A multiple case study of stakeholder perspectives

et al. 2020

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Objective: The study’s aim was to gain insights into factors influencing sustainable return to work following total knee arthroplasty (TKA). Design: A descriptive multiple-case design was used. A case was defined as a worker’s following TKA work disability situation. Settings: The cases came from public hospitals in urban and semi-urban areas in Quebec (Canada) and involved mostly non-work-related TKAs. Subjects: Workers had to be between 6 and 12 months post-TKA, have physical/manual jobs and currently employed. Their rehabilitation professionals and workplace representatives (employer and/or union) were also recruited, based on the work disability paradigm. Main measures: Semi-structured interviews, questionnaires on pain, physical work demands (workers only), and observation of the work activities of those workers back at work were used. Cases were compared and categorized for worker-perceived levels of difficulty in returning to or staying at work: little or no difficulty ( n = 8); some difficulty ( n = 5); not back at work due to excessive difficulty with their knee ( n = 4). Results: A total of 17 cases were constituted. In only one case, the worker benefitted from an interdisciplinary work rehabilitation approach. Results highlight the interplay among these factors: (1) the workers’ perceptions of their residual symptoms and ability to manage them, (2) the interaction between work adjustments and tools offered by the employers and the workers’ own strategies, and (3) perceptions of the workers’ physical capacities. Conclusion: Workers’ who face high levels of work demands/difficulties and who have limited access to work adjustments and tools should be referred for work rehabilitation.

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“…If patients have limited access to total joint arthroplasty, or have to wait for an extended period on waiting lists, the direct and indirect costs of a nation’s society will increase [ 34 ]. Patient information, The individualised guidance that patients receive is the key to when deciding to undergo elective joint replacement [ 9 ]. Direct, succinct, and transparent information is recommended for communication through the coronavirus crisis [ 4 ].…”

Section: Resultsmentioning

confidence: 99%

Preparation for the next COVID-19 wave: The European Hip Society and European Knee Associates recommendations

Donell

Thaler

Budhiparama³

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To plan for the continuance of elective hip and knee arthroplasty during a resurgence or new wave of COVID-19 infections. Method A systematic review was conducted using the terms "COVID-19" or "SARS-Cov-2" and "second wave". No relevant citations were found to inform on recommendations the plan. Therefore, an expert panel of the European Hip Society and the European Knee Associates was formed to provide the recommendations. Results Overall, the recommendations consider three phases; review of the first wave, preparation for the next wave, and during the next wave. International and national policies will drive most of the management. The recommendations focus on the preparation phase and, in particular, the actions that the individual surgeon needs to undertake to continue with, and practice, elective arthroplasty during the next wave, as well as planning their personal and their family's lives. The recommendations expect rigorous data collection during the next wave, so that a cycle of continuous improvement is created to take account of any future waves. Conclusions The recommendations for planning to continue elective hip and knee arthroplasty during a new phase of the SARS-Cov-2 pandemic provide a framework to reduce the risk of a complete shutdown of elective surgery. This involves engaging with hospital managers and other specialities in the planning process. Individuals have responsibilities to themselves, their colleagues, and their families, beyond the actual delivery of elective arthroplasty.

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Experiences of pre- and postoperative information among patients undergoing knee arthroplasty: a systematic review and narrative synthesis

Cited by 23 publications

References 85 publications

Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study

Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study

Return to work following total knee arthroplasty: A multiple case study of stakeholder perspectives

Preparation for the next COVID-19 wave: The European Hip Society and European Knee Associates recommendations

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