Knee Surgeon's Expectations May Differ From Yours

Before getting replacement joint, have a frank talk with your doctor, researchers say

msn.com—March 12, 2010

Doctors and patients often have different expectations for knee and hip replacement surgery, and steps should be taken to close that gap, a new study shows.

Hospital for Special Surgery researchers compared the expectations of 42 patients and their doctors and found clinically meaningful disagreement in 68 percent of patients, with 53 percent of the patients' expectations exceeding those of the surgeons.

"The take-home message for the surgeon is that inexpensive, educational interventions like a preoperative class can be used to better align the patient's and the surgeon's expectations prior to surgery," said Alejandro Gonzales Della Valle, M.D., associate attending orthopedic surgeon at HSS. "This may ultimately result in higher perceived outcome."

"If a patient has unrealistic expectations that are not properly trimmed preoperatively or achieved after surgery, the patient will most likely be dissatisfied with some aspects of the final result. Conversely, if the patient has low expectations for function after surgery, it is likely that he or she will not enthusiastically engage in the different phases of the postoperative recovery including physically therapy. That patient will probably have a lower than expected functional result," Gonzalez Della Valle said.

"For the patient, the take-home message is that it is paramount to discuss the expectations for pain relief and function with the surgeon and in the class before undergoing a total joint replacement to make sure that the expectations of the physician and the patient are similar."

The study was presented this week at the annual meeting of the American Academy of Orthopaedic Surgeons.

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