title: Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties.
abstract: Patients have multiple expectations of THA and TKA. We asked whether preoperative educational classes addressing recovery during the first year could modify patients' expectations of their 12-month postoperative recovery. Participants were enrolled consecutively in two randomized, controlled trials, one for THA (177 patients) and one for TKA (143 patients). Control patients preoperatively received a standard THA or TKA class addressing recovery immediately after surgery. Intervention patients preoperatively received the standard class plus a joint-specific module addressing recovery during the first 12 months. Before and after the class, patients completed either a hip-specific or knee-specific validated expectations survey. The main outcome was the within-patient change in expectation scores (maximum increase, +100; maximum decrease, -100) before and after the class but preoperatively. Mean changes in hip scores were +3.3+/-8 for intervention patients (range, -22+/-32) and +4.9+/-8 for control patients (range, -13+/-29). Mean changes in knee scores were -3.4+/-10 for intervention patients (range, -26+/-33) and +2.4+/-10 for control patients (range, -30+/-30). Patients' preoperative expectations of their recovery from THA or TKA can be modified by preoperative educational classes.
  
  
  METHODS
  Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Medicine, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. mancusoc@hss.edu
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mancuso
authors.forename: Suzanne
authors.initials: S
authors.lastname: Graziano
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Briskie
authors.forename: Margaret G E
authors.initials: MG
authors.lastname: Peterson
authors.forename: Paul M
authors.initials: PM
authors.lastname: Pellicci
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Salvati
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology* / Q000534:rehabilitation; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D020127:Recovery of Function