Original article
Patients' expectations and satisfaction with total hip arthroplasty

https://doi.org/10.1016/S0883-5403(97)90194-7Get rights and content

Abstract

Although there have been many studies focusing on the increasingly important assessment of patients' satisfaction, few studies have specifically addressed this issue for total hip arthroplasty (THA). The goals of this study were to measure patients' satisfaction with THA and to evaluate the relationships of expectations and outcome to patients' satisfaction. A total of 180 patients were surveyed 2 to 3 years after THA about their experiences with THA. Patients cited 45 different expectations, which were grouped into five categories reflecting improvement in pain, walking, psychological state, essential activities, and nonessential activities. Overall, 89% of patients were satisfied with the results of surgery. Lower rates of satisfaction were found in patients who had a better preoperative condition (as measured by the surgeons with The Hospital for Special Surgery Hip Scale), in patients who expected improvement in nonessential activities, and in patients who reported worse postoperative condition (as measured by self-assessment with the Hip Rating Questionnaire and the Medical Outcomes Study Short-form General Health Survey). Patients were also asked how they came to THA. Nearly 50% of patients were first referred to an orthopaedist by family or friends or based on their own knowledge. Seventy-four percent either had subsequently referred others for THA or would have done so if they knew someone with hip pain. This study demonstrates that satisfaction with THA is a complex phenomenon, affected by expectations, outcome, and what patients know about the procedure from their community network. A better understanding of THA satisfaction will enable better future selection of patients and an additional dimension of outcome, both of which are important to patients and payers.

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      To the best of our knowledge, the HSS-HRES is the only validated expectation questionnaire in the THA context [14]. It was developed by Mancuso et al [4] in a cohort of 180 THA patients, who were interviewed 2-3 years after surgery and asked an open-ended expectation question. Forty-five different expectations were obtained which were summarized into 18 items [17,42].

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    Supported in part by The Hospital for Special Surgery Multipurpose Arthritis and Musculoskeletal Disease Center (NIH P60 AR38520-06) (C.A.M., N.A.J., M.E.C., M.G.E.P.); by Ms. Emma A. Daniels, President of the Mary Ellen and Gerald Ritter Foundation; and by Dr. and Mrs. Gianbattista Foglia (E.A.S.).

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