title: Associations between patient expectations of joint arthroplasty surgery and pre- and post-operative clinical status.
abstract: Improvements in implant materials and designs have broadened surgical indications and improved the technical successes of joint arthroplasty surgery. Nevertheless, a small but notable proportion of patients remain dissatisfied despite technically successful surgery. Given reported associations between unfulfilled patient expectations and dissatisfaction, we performed a systematic review to investigate the current state of knowledge concerning potential associations between clinical status and patient expectations of joint arthroplasty procedures. A wide range of expectation assessment instruments was identified, some of which assessed probabilistic expectations and other value-based expectations. Consistent associations were identified between probabilistic expectations of surgery and better pre-operative disease-specific and general health status, as well as more desirable post-operative disease specific scores. In contrast, no consistent associations were identified between clinical status and value-based expectations. Fulfillment of expectations was consistently associated with superior disease-specific and general health absolute and change scores, irrespective of the expectations paradigm used.
authors.affiliation: University of Toronto - Division of Orthopaedic Surgery, Toronto Western Hospital, 399 Bathurst St., 446, 1 East Wing, Toronto, Ontario M5T 2S8, Canada.
authors.forename: Bailey A
authors.initials: BA
authors.lastname: Dyck
authors.forename: Michael G
authors.initials: MG
authors.lastname: Zywiel
authors.forename: Anisah
authors.initials: A
authors.lastname: Mahomed
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gandhi
authors.forename: Anthony V
authors.initials: AV
authors.lastname: Perruccio
authors.forename: Nizar N
authors.initials: NN
authors.lastname: Mahomed
mesh_terms: D001178:Arthroplasty; D006801:Humans; D007596:Joints / Q000601:surgery*; D017060:Patient Satisfaction; D011182:Postoperative Care; D011300:Preoperative Care; D016896:Treatment Outcome
keywords: joint replacement; orthopaedic surgery; patient reported outcomes; reimbursement; satisfaction