Modifying Patient Expectations before Total Knee Replacement Using a Structured Preoperative Education Module

Abstract

Introduction: Unmet expectations after total knee replacement (TKR) is a major reason for patient dissatisfaction after TKR. Preoperative education regarding realistic expectations after TKR may potentially serve as a means of modifying patient’s preoperative expectations and eliminating unreasonable expectations. Methods: A total of 86 patients were randomised to either standardised preoperative education (control, n=37) or usual education with the addition of a module regarding realistic expectations for long-term recovery after TKR (intervention group, n=49). The Hospital for Special Surgery (HSS) Knee Replacement Expectations Survey was used to assess patient’s expectations after education. Knee Society Knee Score (KSKS), Knee Society Functional Assessment (KSFA), and patientreported satisfaction scores were assessed at 6 weeks and 3 months after surgery. Results: Overall, 73% of patients expect complete alleviation of knee pain after surgery and 78% of patients expect to be able to walk for long distances (>2 km). No significant difference in the baseline characteristics of the control and intervention groups was noted. Average preoperative HSS expectations score was 30.7 and 32.2 in the intervention and control groups, respectively (p=0.306). No significant difference was noted in the satisfaction, KSKS and KSFA scores at 6 weeks and 3 months after surgery. Conclusion: Overall, patients have high expectations for long-term recovery after TKR. The HSS expectations scores were lower in the intervention group than in the control group but this was not significant. Further study into methods of modifying patient expectations is warranted.