Discordance in TKA expectations between patients and surgeons

Area of Science:

• Orthopedic surgery
• Patient expectations
• Total knee arthroplasty (TKA)

Background:

• Aligning patient and surgeon expectations preoperatively is crucial for improving outcomes and satisfaction.
• Discordant expectations can negatively impact postoperative compliance and rehabilitation.

Purpose of the Study:

• To determine the rate of discordantly high patient expectations in TKA patients.
• To evaluate the impact of preoperative education, patient characteristics, and functional status on expectation discrepancies.

Main Methods:

• 205 patients awaiting TKA completed a validated expectations questionnaire.
• Surgeons completed the same questionnaire preoperatively, blinded to patient responses.
• Discordantly high expectations were defined as patient scores ≥ 7 points higher than surgeon scores; regression analysis was used.

Main Results:

• 37% of patients had discordantly high expectations compared to their surgeons.
• Female patients and those with higher pain levels were less likely to have discordant expectations.
• Patients surveyed before the preoperative educational class were more likely to have discordant expectations.

Conclusions:

• Increasing TKA use will likely lead to more patients with discordantly high expectations.
• Preoperative educational classes can effectively target and manage patients with unrealistic expectations.