Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

Tsjitske M Haanstra; Tobias van den Berg; Raymond W Ostelo; Rudolf W Poolman; Ilse P Jansma; Pim Cuijpers; Henrica CW de Vet

doi:10.1186/1477-7525-10-152

Health and Quality of Life Outcomes

Table 1 Characteristics of the included studies

From: Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

Study	Quality score (%)	N	Hip or knee	Type of expectations	Measure of expectations	Timing of expectation measurement	Health outcome measures	Timing of outcome measures
Vd Akker-Scheek 2007[30]	79	123	Knee	Self efficacy expectations	- Self efficacy for rehabilitation outcome scale	6 weeks prior to surgery	1. WOMAC overall score	6 months post surgery
							2. SF-36 physical function
Arden 2011[35]	50	799	Hip	Outcome expectations	2 items	Pre-operative	1. Satisfaction	1 year and 2 years post surgery
Arden 2011[35]	50	799	Hip	Outcome expectations	- How painful do you expect your hip to be when you are fully recovered from surgery (not at all painful, slightly painful, very painful)	No specific time point reported	2. Change in oxford hip score	1 year and 2 years post surgery
					- How limited do you expect to be in your usual activities when you are fully recovered from surgery (not limited at all, slightly limited, moderately limited, greatly limited)
Brokelman 2008[24]	50	44	Knee and hip	Outcome expectations	- VAS (0–100) for expectation of satisfaction with surgery 1 year postoperative	After pre-operative information meeting	1. VAS for Satisfaction	Mean = 13.1 months post surgery
Cross 2009[16]	39	106	Knee and hip	Outcome expectations	- Hospital for Special Surgery Hip or Knee Replacement Expectations Questionnaire	Pre-operative	1. WOMAC pain change	6 months post surgery
Cross 2009[16]	39	106	Knee and hip	Self efficacy expectations	- Arthritis Self Efficacy Scale	No specific time point reported	2. WOMAC function change	6 months post surgery
							3. WOMAC stiffness change
Engel 2004[25]	58	78	Knee	Outcome expectations	- Expected probability of recovery (VAS)	2 weeks prior to surgery	1. WOMAC pain	6 months post surgery
				Self efficacy expectations	- Expected change in quality of life (4 response choices)		2. WOMAC function
				Self efficacy expectations	- Coping efficacy (two items, 5 point Likert-type scaled)		3. WOMAC stiffness
							4. Overall recovery (clinician assessment)
Gandhi 2009[14]	58	2350	Knee and hip	Outcome expectations	3 ‘open’ questions	Pre-operative	1. WOMAC pain change	1 year post surgery
					- Time to fully recover from surgery	No specific time point reported	2. WOMAC function change
					- Pain expected after surgery
					- Ability to perform usual activities when recovered
Hartley 2008[36]	53	100	Knee and hip	Self efficacy expectations	- Self efficacy for rehabilitation outcome scale	1 month prior to surgery	1. Harris Hip Scale / The American Knee Society Score (function)	6 weeks post surgery
					- 12 items about outcome expectations with Likert type scales from 0–10.
Judge 2011[34]	63	1327	Hip	Outcome expectations	Number of expectations answered on the following open answered item:	Pre-operative	1. Improved/not improved according to the OMERACT-	1 year post surgery
					- What things do you think your might be able to do in a year’s time, that you NEED to be able to do, but CANNOT do now, if the operation is a total succes	No specific time point reported	OARSI criteria
							2. WOMAC pain
							3. WOMAC stiffness
							4. WOMAC function
Lingard 2006[26]	53	598	Knee	Outcome expectations	4 items answered on a 5 point Likert-type scale (not at all important – very important).	6 weeks prior to surgery		1 year post surgery
					- Expectations regarding pain level		1. WOMAC pain
					- Expectations regarding walking distance		2. WOMAC function
					- Expectations regarding limitation of recreational activity		3. Satisfaction
					- Expectations regarding the use of a walking aid
Lopez-Olivo 2011[32]	74	272	Knee	Self efficacy expectations	Arthritis Self Efficacy Scale	Within a month prior to surgery	1. WOMAC pain	6 months post surgery
							2. WOMAC function
							3. KSRS total
							4. KSRS knee score
							5. KSRS function
Mahomed 2002[15]	58	222	Knee and hip	Outcome expectations	2 items answered on a 4 point Likert type scale	Prior to surgery	1. WOMAC pain	6 months post surgery
					- Limitations in activities of daily living	No specific time point stated	2. WOMAC function
					- Pain relief		3. WOMAC stiffness
					2 items answered on a VAS 0-100
					- Overall success
					- Likelihood of complications
Mannion 2009[27]	58	146	Knee	Outcome expectations	- Expected time to full recovery (open answer in months)	Approximately 2 weeks prior to surgery	1. Global outcome/result of surgery	2 years post surgery
Mannion 2009[27]	58	146	Knee	Outcome expectations	- Expected pain after recovery from surgery (not at all through very painfull)		2. Satisfaction with surgery	2 years post surgery
					- Expected limitations in everyday activities after recovery from surgery (not at all limited through greatly limited)
Nilsdotter 2009[28]	44	102	Knee	Outcome expectations	-Expectations in relation to walking ability measured on a 6 point likert type scale	Pre-operative, no exact time point stated	1. SF-36 physical function	6 months,
								1 year and
								5 years post surgery
					-Expectations in relation to leisure activities measured on a 7 point likert scale
					-Estimated time to recovery. And also about the 5 KOOS domains
					-Expectations dichotomized in high and low expectations
Oettingen 2002[33]	68	51	Hip	Outcome expectations	5 items answered on 5 point Likert type scales combined in a single score.	On the day of admission to the hospital	1. Range of hip motion (3 items, rated by PT)	Two weeks post surgery
					-How likely do you think it is that two weeks after surgery you will be able to go for a brief walk using an assistive cane		2. Walking on stairs (1 item rated by PT),
					-How likely do you think it is that two weeks after surgery you will be walking on stairs up and down with the help of an assistive cane?		3. Recovery. How well the patient does in comparison to other patients (4 items, rated by PT)
					-How functionally able do you think you will be 3 months after surgery		Al questions were answered on a 5 point likert type scale.
					-To what extent do you think you will be without pain 3 months after surgery		Al questions were answered on a 5 point likert type scale.
Quintana 2009[17]	74	788	Hip	Outcome expectations	1 item about expectation of pain relief	Whilst patients were on the waiting list	1. WOMAC pain	6 months and 2 years post surgery
Quintana 2009[17]	74	788	Hip	Outcome expectations	1 item about expectation of pain relief	Whilst patients were on the waiting list	2. WOMAC function	6 months and 2 years post surgery
							3. WOMAC stiffness
Riddle 2009[29]	68	157	Knee	Self efficacy expectations	Arthritis self efficacy scale short form	Preoperatively, no specific time point mentioned	1. WOMAC pain	6 months post surgery
							2. WOMAC function
Suda 2010[37]	6	130	Knee and hip	Outcome expectations	Expectations in relation to 5 items:	1 month pre-operative	1. Harris Hip scores	3 years post surgery
					-Pain
					-Change in personal relationships
					-Decrease in worries about life
					-Resuming old hobbies
					-Overall expectations of the new joint
					-The FFbH-OA-survey adapted to expectations
Vissers 2010[31]	61	45	Knee	Outcome expectations	2 items answered on a 4 point Likert type scale	+− 6 weeks pre-operative	1. Satisfaction with surgery	6 months post surgery
					-Limitations in activities of daily living
					-Pain relief
					1 item answered on a VAS 0-100
					-Overall success

WOMAC= Western Ontario and McMaster Universities Arthritis Index, VAS= Visual Analogue Scale, PT=Physiotherapist, KOOS=Knee injury and Osteoarthritis Outcome Score, FFbH-OA= Functional Questionnaire of Hannover for Osteoarthritis, KSRS= Knee Society Rating System.

Back to article page