Rheumatoid arthritis patients display low expectations for knee replacement

OrthoSuperSite—November 9, 2011

When compared with patients with osteoarthritis, patients with rheumatoid arthritis who are set to undergo total knee replacement display lower expectations about postoperative outcomes, according to researchers at Hospital for Special Surgery.

The lowered expectations, the authors noted in a Hospital for Special Surgery news release, could cause a lack of motivation in some patients with regard to their postoperative rehabilitation. The study was presented at the 2011 Annual Meeting of the American College of Rheumatology.

“If rheumatoid arthritis patients are healthy enough to have surgery, they should really expect good outcomes,” study author Lisa A. Mandl, MD, MPH, stated in the release. “If patients have lower expectations, then maybe they don’t push their physical therapy, and perhaps don’t recover as well. It would be a shame if these patients could have significantly improved function, but for some reason they don’t attain it, perhaps connected to their expectations.”

The authors matched 62 patients who had rheumatoid arthritis (RA) and were undergoing total knee arthroplasty (TKA) to 124 similar patients with osteoarthritis (OA) undergoing TKA. Patients were drawn from the Hospital for Special Surgery (HSS) Total Joint Replacement Registry. Patient expectations, according to the study abstract, were evaluated through the HSS Expectations Survey.

According to the study results, RA patients’ expectations scores were significantly lower than OA patients’ scores. RA patients were also found to have lower ED-5Q scale scores, which the authors suggested meant RA patients could place a lower value on their current health state.

“When people report if they are satisfied, a lot of it is not just related to actual objective measures,” Mandl stated. “It has to do with their expectations preoperatively. If you don’t expect much and you don’t get much, you could be pretty happy … they kind of give up after that.”

Reference:
Ghomrawi H, Mandl LA, Johnson B, et al. Do rheumatoid arthritis patients expect less from total knee arthroplasty? Paper #1694. Presented at the 2011 Annual Meeting of the American College of Rheumatology. Nov. 4-9. Chicago.

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