Patients' Expectations, Experiences and the Determinants of Satisfaction related to Metacarpophalangeal Arthroplasty

Abstract

Joint goal-setting is essential for understanding patients' unique reasons for undergoing MCP arthroplasty and facilitating realistic expectations. Education on all aspects of postoperative care is vital. Patients should be made aware of variability in outcome and the potential for deterioration due to the chronic nature of rheumatoid arthritis.

Preoperative Expectations in Hand Surgery Patients

“…It has been previously shown that fulfillment of expectations seems to be one of the most important factors of postoperative satisfaction following hand surgery. 25 26 27 28 Surgeon factors and patient-specific factors such as employment or marital status may also play a role in satisfaction, although it was interesting to note that these factors were not significantly associated with expectations in our study. Furthermore, coexisting mental health conditions could impact satisfaction through a psychiatric lens.…”

“…Because of these points, making sure that comprehensive, individualized, and realistic expectations are communicated to the patient prior to surgery is imperative. 26,27,[49][50][51] This will help ensure that the patient has balanced expectations of the outcome, and can help prevent dissatisfaction despite a "successful" surgery. This has been discussed in many different surgical populations [11][12][13][14]22,32,52 and is an important trend in orthopaedic surgery with the recent emphasis on PROs.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24] In populations of hand surgery patients being treated for conditions such as carpal tunnel syndrome and basal joint osteoarthritis, fulfillment of expectations was one of the best predictors of postoperative satisfaction. [25][26][27][28] Furthermore, studies have found that there are certain patient characteristics that may have an association with preoperative expectations. 11,18,20,21,[29][30][31][32][33] Feucht et al found that younger and more active patients undergoing ACL reconstruction had higher expectations.…”

A reflection of outcomes research and its impact on the practice of hand surgery

“…Another important outcomes metric for hand surgery is the concept of expectation. Studies have shown that outcomes are generally better when patients’ expectations are high but rational (Lutz et al, 1999; Sharrock et al, 2013). By applying psychometric principles in developing expectation questionnaires in hand surgery, hand surgeons can better link the elusive outcomes goal of patient satisfaction as a new dimension of outcomes research.…”