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Relationship between Preoperative Patient Characteristics and Expectations in Candidates for Total Knee Arthroplasty
Helen Razmjou1, Joel A Finkelstein, Albert Yee
1Helen Razmjou, MSC, PhD(C): Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre; Department of Physical Therapy, University of Toronto, Toronto, Ontario.
Purpose:
The purpose of this study was to determine the relationship between patient expectations for improvement following primary total knee arthroplasty (TKA) and patient preoperative characteristics.
Methods:
This was a cross-sectional analysis of preoperative expectations. Expectations for improvement were evaluated in six distinct domains. The baseline factors used as independent variables were age, gender, presence of comorbidity, sub-domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; pain, stiffness, physical limitation related to lower extremity), and SF-36 physical and mental health component scores. Stepwise logistic regression analysis was applied to examine the relationships between dependent and independent variables.
Results:
The study cohort consisted of 236 candidates for TKA (154 women and 82 men, mean age 67, SD = 9.98). Expectations were high on average. Presence of comorbidity was associated with expectations of pain relief. Preoperative mental health was related to expectations for a return to activities of daily living; age, gender, physical health, and mental health were related to expectations for improved leisure, recreational, and sports activities. Preoperative physical health was related to expectations for potential return to full recovery. No baseline factors were associated with expectations for improved range of motion or for providing care to and interacting with others.
Conclusion:
Expectations related to recovery from surgery appeared to have distinct dimensions and were associated with patient baseline characteristics.
