Comparison of Patient and Surgeon Expectations of Total Hip Arthroplasty

Abstract

ObjectivesAnalysis of discrepancies between patient and surgeon expectations before total hip arthroplasty (THA) should enable a better understanding of motives of dissatisfaction about surgery, but this question has been seldom studied. Our objectives were to compare surgeons' and patients' expectations before THA, and to study factors which affected surgeon-patient agreement.Methods132 adults (mean age 62.8+/−13.7 years, 52% men) on waiting list for THA in three tertiary care centres and their 16 surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (range 0–100). Patients' and surgeons' answers were compared, for the total score and for the score of each item. Univariate analyses tested the effect of patients' characteristics on surgeons' and patients' expectations separately, and on surgeon-patient differences.ResultsSurgeon and patient expectations' mean scores were high (respectively 90.9+/−11.1 and 90.0+/−11.6 over 100). Surgeons' and patients' expectations showed no systematic difference, but there was little agreement on Bland and Altman graph and correlation coefficient was low. Patients had higher expectations than surgeons for sports. Patients rated their expectations according to trust in physician and mental quality of life, surgeons considered disability. More disabled patients and patients from a low-income professional category were often “more optimistic” than their surgeons.ConclusionSurgeons and patients often do not agree on what to expect from THA. More disabled patients expect better outcomes than their surgeons.

Measuring Expectations in Orthopaedic Surgery: A Systematic Review

“…The experience with the MOD-EMS initiative provided important lessons in terms of developing simple and user-friendly data collection methods, minimizing participant time burden, including rigorous quality control measures, and planning for financial sustainability, which are now being applied to the American Joint Replacement Registry [56]. However, the use of the HSS Expectation Surveys has recently been reported in several clinical studies from nonoriginating investigators [17,24,58,63], which may potentially allow for comparison of patient expectations and their association with other clinical variables between different populations and studies. Additionally, the recent inclusion of an expectations domain in the New Knee Society Score further promises to expand opportunities for the investigation of this variable in patients undergoing TKA [48,59].…”

Survival and functional outcome of the Birmingham Hip Resurfacing system in patients aged 65 and older at up to ten years of follow-up

“…Studies suggest that elderly patients now have increased functional and activity expectations following arthroplasty, and this group may even outlive the lifespan of a standard THR [20,[42][43][44][45]. Hip resurfacing may provide an alternative in this subgroup of elderly patients wishing to maintain high levels of activity, with a previous study demonstrating patients ≥55 years were significantly more likely to participate in athletic activity following hip resurfacing than younger patients [45].…”

An evidence-based review of enhanced recovery interventions in knee replacement surgery

“…We must explore and understand patient expectations in order to achieve the best patient reported outcome 7 while avoiding dissatisfaction from unmet expectations. 8 …”