title: Recovery expectations of hip resurfacing compared to total hip arthroplasty: a matched pairs study.
abstract: OBJECTIVE
  Expectations of higher activity levels associated with hip resurfacing arthroplasty (HRA) may be driving better outcomes in this group compared to total hip arthroplasty (THA). Previous studies evaluated patient expectations before consulting with the surgeon, although these expectations were likely unrealistic and would change after the consultation. We compared HRA and THA patient expectations after consultation with the surgeon.
  
  
  METHODS
  In a prospective registry setting, patients awaiting HRA were matched to THA patients by age, sex, and a preoperative Lower Extremity Activity Scale score (range 1-18, with 18 indicating levels of highest activity). Patients completed preoperatively a validated 18-item expectations survey. Mean overall expectation scores were first compared. Exploratory factor analysis (EFA) was then performed to determine if the grouping of individual expectations items represented meaningfully different underlying factors in the 2 groups.
  
  
  RESULTS
  We matched 123 pairs. The mean ± SD expectation scores were similar (85.2 ± 15.5 for HRA and 87.3 ± 13.9 for THA; P = 0.249). The EFA showed that HRA and THA patients shared the common expectations of pain relief and improvement in daily activities (9 items) and eliminating pain medications, the need for a cane, and improving sexual activity (3 items). THA patients perceived the remaining 6 items as an overall third expectation of participation in higher-level activities. However, HRA patients perceived a fourth expectation of normal range of motion (2 items) independent of the other higher-level activities (4 items).
  
  
  CONCLUSIONS
  Even after consulting with a surgeon, patients' expectations differed between HRA and THA patients regarding higher-level activities. More counseling for patients seeking hip arthroplasty is therefore needed.
authors: Weill Cornell Medical College and Hospital for Special Surgery, New York, New York, USA. hag2008@med.cornell.edu
authors: Hassan M K
authors: HM
authors: Ghomrawi
authors: Mark M
authors: MM
authors: Dolan
authors: John
authors: J
authors: Rutledge
authors: Michael M
authors: MM
authors: Alexiades
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D003376:Counseling; D004185:Disability Evaluation; D005260:Female; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D010361:Patients / Q000523:psychology*; D010465:Perception; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012017:Referral and Consultation; D012042:Registries; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States