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How Often are Patient and Surgeon Recovery Expectations for Total Joint Arthroplasty Aligned? Results of a Pilot Study

  • Ghomrawi, Hassan M. K.1, 2
  • Franco Ferrando, Nuria3
  • Mandl, Lisa A.4
  • Do, Huong2
  • Noor, Neaz1
  • Gonzalez Della Valle, Alejandro5
  • 1 Weill Cornell Medical College, Division of Health Policy Department of Public Health, New York, NY, USA , New York (United States)
  • 2 Hospital for Special Surgery, Epidemiology and Biostatistics Core, New York, NY, USA , New York (United States)
  • 3 Hospital Universitario La Fe, Department of Orthopaedics, Valencia, Spain , Valencia (Spain)
  • 4 Hospital for Special Surgery, Department of Rheumatology, New York, NY, USA , New York (United States)
  • 5 Hospital for Special Surgery, Department of Orthopedic Surgery, 535 East 70th Street, New York, NY, 10021, USA , New York (United States)
Published Article
HSS Journal ®
Springer New York
Publication Date
Jun 25, 2011
DOI: 10.1007/s11420-011-9203-6
Springer Nature


BackgroundSurgeons strive to set patient expectations for recovery following total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, some patients report dissatisfaction after surgery due to unmet expectations.PurposeWe compared patients’ and surgeon’s recovery expectations prior to primary THA and TKA.MethodsSixty eight patients scheduled to undergo primary total hip replacement (THR) or total knee replacement (TKR) surgery were enrolled. Before surgery, patients filled out a validated recovery expectations questionnaire that quantified expectations of postoperative pain relief, function, and well-being with a value from 0 to 100 (higher being more optimistic). The surgeon independently completed the same questionnaire for each patient. Overall score and item-specific comparisons were conducted. Correlations were explored between agreement level, demographics, patient-reported health status measures, and patients’ assessments of the risk of complications associated with surgery.ResultsMost patients undergoing THR or TKR had higher expectations for recovery than their surgeon. Applying the clinically meaningful difference in expectations (≥7 points), 52.5% of the TKA patients’ expectations exceeded those of the surgeon, while 22.5% expected less than their surgeon and 60.7% of THA patients’ expectations exceeded those of the surgeon, while 21.4% expected less than their surgeon. THA patients with either lower or higher expectations than their surgeon had lower physical and mental health status scores. TKA patients with lower expectations compared to their surgeon had a higher expectation of complications.ConclusionsMore than 50% of the patients had higher expectations than their surgeon and this was driven by expectations of high-level activities and extreme range of motion. Further investigations are needed to understand these differences so as to enhance patient preoperative education.

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