Perceptions of, and willingness to consider, total joint arthroplasty in a population-based cohort of individuals with disabling hip and knee arthritis.
OBJECTIVE
To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA.


METHODS
A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects > or =55 years with disabling hip or knee arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire.


RESULTS
Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR] <75 versus > or =75 years 2.42, P = 0.01); worse perceived arthritis severity (OR per unit increase 1.30, P < 0.001); perceiving TJA as appropriate for moderate, controlled joint pain (OR 3.29, P = 0.004); walking limited to <1 block (OR 1.99, P = 0.015); the risk of revision as acceptable (OR 3.73, P < 0.001); and friends as an important health information source (OR 2.49, P = 0.01).


CONCLUSIONS
Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.
Hawker
Gillian A
GA
University of Toronto, Sunnybrook and Women's College Health Sciences Centre, University Health Network Research Institute, and Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. g.hawker@utoronto.ca
Wright
James G
JG
Badley
Elizabeth M
EM
Coyte
Peter C
PC
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology*; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology*; D001290:Attitude; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015207:Osteoarthritis, Hip / Q000523:psychology / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000601:surgery*; D017060:Patient Satisfaction; D010465:Perception