Patients' Expectations Impact Their Satisfaction following Total Hip or Knee Arthroplasty.
Patients' Expectations Impact Their Satisfaction following Total Hip or Knee Arthroplasty.
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DOI：
10.1371/journal.pone.0167911
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Reginster JY
中科院分区：
文献类型：
--
作者：
Neuprez A;Delcour JP;Fatemi F;Gillet P;Crielaard JM;Bruyère O;Reginster JY
本研究的目的是评估严重和疼痛的骨关节炎(OA)患者行全髋关节置换术(THA)或全膝关节置换术(TKA)后一年的满意度与术前期望的数量和程度之间的关系。术前期望(在手术前20天内)和术后满意度(干预后一年)使用先前经过验证的法国版的特殊外科医院髋关节或膝关节置换期望调查来衡量。术后满意度的测量使用特定的量表，遵循与评估期望相同的方法。使用多元线性回归模型预测患者的满意度。共有138名患者(80例全膝关节置换术和58例全膝关节置换术)完成了这两部分研究。期望得分(0~100)分别为(72.58±12.63)分和(69.10±13.72)分(p=0.13)。TKA前的期望值为14.34±1.32(满分为18)，TKA前为14.70±2.29(满分为19)。1年后，THA的满意度显著高于TKA(69.70±14.46v60.44±17.54，p<；0.001)。对于TKA和THA，术前期望评分是术后满意度评估的唯一最好的正向预测因子。接受全关节置换术治疗终末期骨性关节炎的患者在全髋关节置换术和全膝关节置换术前都有很高的期望值。虽然这两种类型的干预措施都显著改善了基本和非基本活动，但THA后的满意率明显更高。术前期望值是影响术后一年最终满意度的主要因素。这些结果再次强调了需要在医疗保健提供者和患者之间进行最佳的术前互动，使患者有机会预见TJA术后的合理结果。
The objective of this study was to assess the number and magnitude of preoperative expectations and to correlate them with the degree of satisfaction expressed one year after Total Hip Arthroplasty (THA) or Total Knee Arthroplasty (TKA), in patients with severe and painful osteoarthritis (OA). Preoperative expectations (within 20 days prior to surgery) and postoperative satisfaction (one year after the intervention) were measured using the previously validated French version of the Hospital for Special Surgery Hip or Knee Replacement Expectations Survey. Postoperative satisfaction was measured using a specific scale, following the same methodology as that used for the assessment of expectations. Prediction of the satisfaction of the patients was performed using multivariate linear regression modelling. A total of 138 patients (80 THA and 58 TKA) completed the two parts of the study. The expectations score (mean ± SD) (range 0–100) was 72.58 ± 12.63 before THA and 69.10 ± 13.72 before TKA (p = 0.13). The number of expectations expressed was 14.34 ± 1.32 (out of a potential maximum of 18) before THA and 14.70 ± 2.29 (out of a potential maximum of 19) before TKA. After 1 year, THA generated a significantly higher degree of satisfaction compared to TKA (69.70 ± 14.46 v 60.44 ± 17.54, p<0.001) (range 0–100). The pre-operative expectations score was the single best positive predictor of the post-surgery satisfaction assessment both for TKA and THA. Patients undergoing total joint arthroplasty for end-stage OA have a high level of expectations, before both THA and TKA. While both types of interventions significantly improve essential and non-essential activities, the rate of satisfaction is significantly greater post THA. Preoperative expectations are a major contributor to the final degree of satisfaction, one year after surgery. These results re-emphasize the need for an optimal preoperative interaction between health care providers and patients, to allow patients a chance to foresee a reasonable outcome after TJA.