title: Comparison of patient and surgeon expectations of total hip arthroplasty.
abstract: OBJECTIVE
  Analysis of discrepancies between patient and surgeon expectations before total hip arthroplasty (THA) should enable a better understanding of motives of dissatisfaction about surgery, but this question has been seldom studied. Our objectives were to compare surgeons' and patients' expectations before THA, and to study factors which affected surgeon-patient agreement.
  
  
  METHODS
  132 adults (mean age 62.8+/-13.7 years, 52% men) on waiting list for THA in three tertiary care centres and their 16 surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (range 0-100). Patients' and surgeons' answers were compared, for the total score and for the score of each item. Univariate analyses tested the effect of patients' characteristics on surgeons' and patients' expectations separately, and on surgeon-patient differences.
  
  
  RESULTS
  Surgeon and patient expectations' mean scores were high (respectively 90.9+/-11.1 and 90.0+/-11.6 over 100). Surgeons' and patients' expectations showed no systematic difference, but there was little agreement on Bland and Altman graph and correlation coefficient was low. Patients had higher expectations than surgeons for sports. Patients rated their expectations according to trust in physician and mental quality of life, surgeons considered disability. More disabled patients and patients from a low-income professional category were often "more optimistic" than their surgeons.
  
  
  CONCLUSIONS
  Surgeons and patients often do not agree on what to expect from THA. More disabled patients expect better outcomes than their surgeons.
authors.affiliation: AP-HP, Hôpital R. Poincaré, Service de Médecine Physique et Réadaptation, Garches, France. claire.jourdan@rpc.aphp.fr
authors.forename: Claire
authors.initials: C
authors.lastname: Jourdan
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
authors.forename: Stéphane
authors.initials: S
authors.lastname: Descamps
authors.forename: Rémy
authors.initials: R
authors.lastname: Nizard
authors.forename: Moussa
authors.initials: M
authors.lastname: Hamadouche
authors.forename: Philippe
authors.initials: P
authors.lastname: Anract
authors.forename: Stéphane
authors.initials: S
authors.lastname: Boisgard
authors.forename: Myriam
authors.initials: M
authors.lastname: Galvin
authors.forename: Philippe
authors.initials: P
authors.lastname: Ravaud
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology*; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D057234:Preoperative Period; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult