title: How do we face patients' expectations in joint arthroplasty?
abstract: BACKGROUND
  Patients' expectations have become increasingly important over the last decade, as the fulfilment of preoperative expectations has been shown to be associated with postoperative satisfaction. Understanding the pattern of patients' expectations is necessary to provide a better basis for recommendations to patients opting for arthroplasty. The aim of this study was to show patients' expectations of joint replacement surgery in Germany and to elucidate factors, which might have an influence.
  
  
  METHODS
  A retrospective analysis of anonymously collected data was performed on people participating in a patient information event for joint replacement surgery. They were asked to complete a survey, which consisted of five questions requesting demographic data and three questions regarding preoperative expectations. The latter were taken from the New Knee Society Score. An expectation score (0-12 points) was generated by adding the single point values of the three questions.
  
  
  RESULTS
  180 attendees were included in this study. The distribution of patients' expectations was remarkably skewed towards high expectations, the mean expectation score was 10.17. 87.2 % of participants had high and very high expectations and only 12.8 % had low and moderate expectations. Patients' expectations were independent of age and previous participation in a patient information event. Female gender and a history of arthroplasty led to a slightly higher expectation score. Patients with isolated knee pain had significantly lower expectations than patients suffering from isolated hip pain.
  
  
  CONCLUSIONS
  This study shows that the majority of patients have high expectations regarding joint replacement surgery. To improve postoperative patients' satisfaction a straightforward physician-patient communication is necessary to prevent patients from potentially unrealistic expectations and therefore dissatisfaction with surgery.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne-Merheim Medical Center, Ostmerheimer Str. 200, 51109, Cologne, Germany, Paola.koenen@googlemail.com.
authors.forename: Paola
authors.initials: P
authors.lastname: Koenen
authors.forename: Holger
authors.initials: H
authors.lastname: Bäthis
authors.forename: Marco M
authors.initials: MM
authors.lastname: Schneider
authors.forename: Matthias
authors.initials: M
authors.lastname: Fröhlich
authors.forename: Bertil
authors.initials: B
authors.lastname: Bouillon
authors.forename: Sven
authors.initials: S
authors.lastname: Shafizadeh
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology*; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires