Misconceived expectations: Patient reflections on the total knee replacement journey

Area of Science:

• Orthopedic Surgery
• Patient Expectations
• Qualitative Research

Background:

• Fifty percent of patients undergoing total knee replacement (TKR) have unrealistic expectations regarding the procedure and its outcomes.
• A structured framework is needed to identify and address patient knowledge gaps and misconceptions during the informed consent process.

Purpose of the Study:

• To explore patient knowledge gaps and misconceptions about the total knee replacement (TKR) journey.
• To inform the development of a framework for improving the TKR informed consent process.

Main Methods:

• Qualitative study involving semi-structured interviews with 20 patients 12 months post-TKR.
• Participants reflected on their pre-operative expectations versus actual experiences.
• Inductive thematic analysis of interview transcripts to identify key themes.

Main Results:

• All participants reported discrepancies between anticipated and actual TKR experiences.
• Common misconceptions included overestimating post-surgical pain/function improvements, underestimating recovery time, and misunderstanding anesthesia procedures.
• Patients also struggled with long-term functional limitations.

Conclusions:

• Findings highlight significant knowledge gaps and misconceptions in patients undergoing TKR.
• A preliminary framework of therapeutic misconception is proposed.
• Surgeons can utilize these insights to enhance the TKR informed consent process.