title: Unfulfilled Expectations After Total Hip and Knee Arthroplasty Surgery: There Is a Need for Better Preoperative Patient Information and Education.
abstract: The aims of this study were to assess patients' preoperative expectations of the outcome of total hip or knee arthroplasty (THA/TKA) regarding specific aspects of functioning and to determine to what extent each expectation was fulfilled after 1 year.
  
  
  
  This was a prospective cohort study. Preoperative expectations and their fulfillment after 1 year were measured with the Hospital for Special Surgery Hip/Knee arthroplasty Expectations Surveys. Preoperative and postoperative scores were subtracted to calculate whether expectations were unfulfilled, fulfilled, or exceeded.
  
  
  
  A total of 343 THA and 322 TKA patients with complete follow-up were included. Preoperatively, >60% of patients (both THA/TKA) expected to get back to normal or have much improvement in 19 of 20 (THA) and 12 of 19 (TKA) items. Expectations were fulfilled or exceeded in >60% of patients in all 20 items for THA and 17 of 19 items for TKA. In THA, items with the largest proportions patients with unfulfilled expectations (>30%) were "improvement in walking ability: long distances" (31%), "walking stairs" (33%), and "improve ability to cut toenails" (38%). In TKA, expectations for 12 of 19 items were unfulfilled in >30% of patients, with the largest proportions seen for "being able to kneel down" (44%) and "being able to squat" (47%).
  
  
  
  Although for most items, >60% of THA and TKA patients indicated that their expectations were met or exceeded, there was a substantial number of patients, particularly TKA patients, having unfulfilled expectations. These need more attention in preoperative patient information and education.
authors.affiliation: Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Claire
authors.initials: C
authors.lastname: Tilbury
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Tsjitske M
authors.initials: TM
authors.lastname: Haanstra
authors.affiliation: Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Claudia S
authors.initials: CS
authors.lastname: Leichtenberg
authors.affiliation: Department of Orthopedics, Rijnland Hospital, Leiderdorp, The Netherlands.
authors.forename: Suzan H M
authors.initials: SH
authors.lastname: Verdegaal
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Raymond W
authors.initials: RW
authors.lastname: Ostelo
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
authors.affiliation: Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Rob G H H
authors.initials: RG
authors.lastname: Nelissen
authors.affiliation: Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Thea P M
authors.initials: TP
authors.lastname: Vliet Vlieland
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology*; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016138:Walking
keywords: arthroplasty; expectations; hip; knee; osteoarthritis; patient satisfaction