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.

References (45)

  • KE Burton et al.

    Patients' expectations in relation to outcome of total hip replacement surgery

    Ann Rheum Dis

    (1979)
  • RJ Haworth et al.

    Expectations and outcome of total hip replacement

    Rheum Rehab

    (1981)
  • A Kay et al.

    Hip arthroplasty: patient satisfaction

    Br J Rheum

    (1983)
  • MH Liang et al.

    The total hip arthroplasty outcome evaluation form of the American Academy of Orthopedic Surgeons

    J Bone Joint Surg

    (1991)
  • PD Cleary et al.

    Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California

    JAMA

    (1991)
  • RC Johnston et al.

    Clinical and radiographic evaluation of total hip replacement

    J Bone Joint Surg

    (1990)
  • JN Katz et al.

    Comparative measurement sensitivity of short and longer health status instrument

    Med Care

    (1992)
  • RR Uhlmann et al.

    Patients requests and expectations: definitions and clinical applications

    Med Care

    (1984)
  • AL Stewart et al.

    The MOS short-form general health survey

    Med Care

    (1988)
  • AR Tarlov et al.

    The Medical Outcomes Study

    JAMA

    (1989)
  • NA Johanson et al.

    A self-administered hip-rating questionnaire for the assessment of outcome after total hip replacement

    J Bone Joint Surg

    (1992)
  • Cited by (0)

    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.).

    View full text