Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties
Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties
复制标题
DOI：
10.1007/s11999-007-0052-z
复制
发表时间：
2008-02-01
影响因子：
4.2
通讯作者：
Sculco, Thomas P.
中科院分区：
文献类型：
--
作者：
Mancuso, Carol A.;Graziano, Suzanne;Sculco, Thomas P.
患者对THA和TKA有多种期望。我们询问，在第一年进行针对恢复的术前教育课程是否可以改变患者对术后12个月恢复的期望。参与者连续入组两项随机对照试验，一项为THA（177例患者），一项为TKA（143例患者）。对照组患者术前接受标准THA或TKA分类，以解决术后即刻恢复问题。干预患者术前接受标准分类加上关节特定模块，解决前12个月的恢复问题。在课程前后，患者完成了髋关节特定或膝关节特定的有效期望调查。主要结局是患者内预期评分的变化（最大增加，+100;最大减少，-100），在上课前后，但术前。干预患者髋关节评分的平均变化为+3.3 +/- 8（范围：-22-+32），对照患者为+4.9 +/- 8（范围：-13-+29）。干预患者膝关节评分的平均变化为-3.4 +/-10（范围：-26-+33），对照患者为+2.4 +/-10（范围：-30-+30）。患者术前对THA或TKA恢复的期望可以通过术前教育课程进行调整。
Patients have multiple expectations of THA and TKA. We asked whether preoperative educational classes addressing recovery during the first year could modify patients' expectations of their 12-month postoperative recovery. Participants were enrolled consecutively in two randomized, controlled trials, one for THA (177 patients) and one for TKA (143 patients). Control patients preoperatively received a standard THA or TKA class addressing recovery immediately after surgery. Intervention patients preoperatively received the standard class plus a joint-specific module addressing recovery during the first 12 months. Before and after the class, patients completed either a hip-specific or knee-specific validated expectations survey. The main outcome was the within-patient change in expectation scores (maximum increase, +100; maximum decrease, -100) before and after the class but preoperatively. Mean changes in hip scores were +3.3 +/- 8 for intervention patients (range, -22-+32) and +4.9 +/- 8 for control patients (range, -13-+29). Mean changes in knee scores were -3.4 +/- 10 for intervention patients (range, -26-+33) and +2.4 +/- 10 for control patients (range, -30-+30). Patients' preoperative expectations of their recovery from THA or TKA can be modified by preoperative educational classes.