title: Method for quantifying patient expectations and early recovery after total knee arthroplasty.
abstract: Many components of a surgeon's total knee arthroplasty (TKA) treatment regimen affect the rate of recovery, such as patient selection, preoperative education, surgical technique, pain management, and postoperative rehabilitation. Therefore, accurate counseling requires that the surgeon quantifies patient expectations and early recovery of the treatment regimen with a method that minimizes interviewer bias. Preoperatively and 4 to 5 weeks after TKA, 285 patients (306 consecutive primary TKAs) responded to a survey consisting of customized questions, the Oxford score, the SF-12, and Knee Society scores on a handheld data acquisition device. The average response to each question on the 4- to 5-week postoperative survey defined patient expectations, and the change in a response between the 4- to 5-week postoperative and the preoperative survey determined whether the surgical intervention improved the patient. At 4 to 5 weeks postoperatively, 80% of patients walked without a cane, 54% drove a car, 88% thought the treated knee was functioning better than before surgery, 93.5% thought the treated knee was normal or nearly normal, and 98% thought the alignment of their limb was "just right." By 4 to 5 weeks, patients experienced less pain and showed significant improvements in 11 of 12 activities queried by the Oxford score, SF-12 physical score, Knee function score, Knee Society score, and knee extension. Flexion was significantly less at 4 to 5 weeks, and the SF-12 mental score was not significantly different. Average hospital stay was 2 nights, with 98% discharged home. Surgeons should consider a method that minimizes interviewer bias to quantify patient expectations and rate of recovery of their specific treatment regimen, and then use this information to counsel their patients to avoid disappointment after TKA.
authors.affiliation: Department of Mechanical Engineering, University of California, Davis, USA. sebhowell@mac.com
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Howell
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Rogers
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010358:Patient Participation / Q000379:methods*; D010361:Patients; D011795:Surveys and Questionnaires