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Listen Up, Doc: What Patients Expect from Knee Surgery

Whether or not patients get medical treatment has a lot to do with how they think treatment will help them, physically and otherwise. Patients' expectations of treatment also play a part in how satisfied they are with the results.

Say, for example, a patient expects to run a marathon after anterior cruciate ligament (ACL) surgery. If the patient can't run the marathon, he or she may feel let down by the surgery. But if the doctor knows the patient's expectation ahead of time, he or she can address it before surgery. It may be that the patient's goals can't be met by the treatment. In this case, the doctor can talk with the patient about other options.

These authors wanted to find a way to measure patients' expectations of knee surgery. The authors interviewed 377 patients about what they expected from knee surgery. Patients' expectations included improved pain and walking. Patients also expected to be better able to do sports and daily activities. They had some expectations that surprised the authors, such as better emotional well-being.

The authors turned these expectations into questions, to use as a survey. Patients' expectations were different depending on the type of surgery they were about to have. So the authors created two surveys. One was for patients having knee replacement surgery. The other was for patients having general knee surgeries, such as ACL surgery. The surveys were tested on a group of 163 patients. Any questions that weren't reliable were taken out.

There were 52 categories of expectations. Return to sports was a common expectation across the board. Patients having general knee procedures expected to return to "high demand" sports such as basketball and soccer. Seven percent of these patients expected to return to professional sports.

Almost a third of patients who were having general procedures thought the knee would "go back to the way it was." Many of these patients had had specific injuries; they hoped surgery would undo the damage.

Patients had different expectations of knee surgery based on sex, age, and education. Compared to men, women were more likely to expect walking to improve from surgery. Meanwhile, men expected to do better in sports.

Younger patients were more likely to expect better sports performance. Younger patients also thought the knee would go back to the way it was. In comparison, older patients expected less pain and an easier time walking.

Patients with less education thought they'd get pain relief and emotional well-being from surgery. Patients with more education expected to do better in sports.

Patients' expectations also depended on how much they were able to use their knees before surgery. Patients with poor knee function thought surgery would help their walking and emotional well-being. They also expected to go back to work. Meanwhile, patients with better knee function expected to improve in sports.

The authors feel that the surveys developed in this study are reliable and easy to use. They hope doctors will use the surveys to learn more about patients' expectations of knee surgery. By knowing patients' expectations, doctors can give more focused care. They can help patients understand which expectations may be met by a particular treatment. This may help patients make more informed decisions about treatment and feel better about their results.

References: Carol A. Mancuso, MD, et al. Patients' Expectations of Knee Surgery. In The Journal of Bone and Joint Surgery. July 2001. Vol. 83-A. No. 7. Pp. 1005-1012.

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