title: Preoperative education addressing postoperative pain in total joint arthroplasty: review of content and educational delivery methods.
abstract: OBJECTIVE
  Evaluate content and educational delivery methods of preoperative education in total joint arthroplasties of the hip and knee (THA and TKA) addressing postoperative pain.
  
  
  METHODS
  Systematic searches conducted on Biomed Central, BMJ.com, CINAHL, the Cochrane Library, NLM Central Gateway, OVID, ProQuest (Digital Dissertations), PsycInfo, PubMed/Medline, ScienceDirect, and Web of Science. Secondary searching (pearling) was undertaken.
  
  
  METHODS
  Data were extracted utilizing the participants, interventions, comparisons, and outcomes approach.
  
  
  METHODS
  All randomized controlled trials (RCTs) evaluating the effect of preoperative education on postoperative pain in THA and TKA surgery were considered for inclusion.
  
  
  CONCLUSIONS
  Studies published in English; published within the last 20 years and patients over the age of 18. No limitations were set on specific outcome measures of pain.
  
  
  RESULTS
  This review included 13 RCTs involving a total of 1,017 subjects who underwent THA or TKA. Educational delivery methods comprised verbal one-on-one or group education sessions, delivered within 4 weeks of surgery lasting an average of 30 minutes, and accompanied by other written materials. The educational content centered on descriptions of preoperative preparation, hospital stay, surgical procedure, immediate/intermediate experiences, expectations following surgery, rehabilitation, encouragement/reassurance, and answering common question associated with the surgical experience.
  
  
  CONCLUSIONS
  Preoperative education centered on a biomedical model of anatomy and pathoanatomy as well as procedural information has limited effect in reducing postoperative pain after THA and TKA surgeries. Preoperative educational sessions that aim to increase patient knowledge of pain science may be more effective in managing postoperative pain.
authors.affiliation: International Spine Pain Institute and Neuro Orthopaedic Institute, Story City, IA, USA.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Louw
authors.forename: Ina
authors.initials: I
authors.lastname: Diener
authors.forename: David S
authors.initials: DS
authors.lastname: Butler
authors.forename: Emilio J
authors.initials: EJ
authors.lastname: Puentedura
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010465:Perception; D011300:Preoperative Care; D016896:Treatment Outcome