Consent in Elective Hip Arthroplasty What Has Changed Over the Last 15 Years?

It is regular practice that patients undergoing orthopaedic procedures particularly those related to arthroplasty are given both verbal and written information prior to their surgery. The aim of this study was to complete a 15 year audit cycle by assessing the patient understanding of the consent process in elective orthopaedic surgery following the introduction of patient information booklets, DVDs, web links, and "joint school."

150 patients (50 patients in each cycle of the study) undergoing primary total hip arthroplasty were counselled about the audit and prospectively enrolled. Consent was obtained by either the specialist registrar or by the consultant. All patients were asked to complete a questionnaire relating to the consent process. The same questionnaire has been used for the past 15 years.

There was no significant difference in the overall scores of the questionnaires over the past 15 years. There was no significant improvement in the number of patients stating awareness that infection, dislocation, and mortality are potential complications associated with hip arthroplasty.

There have been several technological advances over the past 15 years in an attempt to improve patients' understanding and comprehension of the consent process in total hip replacement surgery. This study has shown that despite these efforts, there has been very little improvement in patients' understanding. However, patients remain satisfied with this extra information. The remaining underlying question is whether patients actually want to know all the potential complications that can occur.