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| Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties |
| Mancuso CA, Graziano S, Briskie LM, Peterson MGE, Pellicci PM, Salvati EA, Sculco TP |
| Clinical Orthopaedics and Related Research 2008 Feb;466(2):424-431 |
| clinical trial |
| 6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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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. LEVEL OF EVIDENCE: Level I, therapeutic study.
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