Audiovisual information in patients undergoing a total knee replacement. Is it important to modify preoperative expectations?
Background: Osteoarthritis of the knee is a prevalent condition where surgical intervention is indicated for patients experiencing persistent pain and functional impairment. While total knee arthroplasty is an established treatment for advanced disease, postoperative satisfaction is frequently mediated by the congruence between preoperative expectations and actual clinical outcomes. Information provided during the preoperative phase is critical in shaping these expectations; however, external social influences and digital media often contribute to unrealistic patient goals, necessitating the investigation of various educational modalities.
Objective: This study aims to evaluate the efficacy of a supplemental audiovisual educational tool in modifying preoperative expectations among patients scheduled for total knee arthroplasty and to identify specific patient biophysical or functional profiles that might demonstrate greater receptivity to this intervention.
Key Points: Data from a prospective randomized trial were analyzed to compare standard verbal information against supplemental audiovisual delivery via videodisc. The primary outcome was the quantitative change in the Hospital for Special Surgery Knee Replacement Expectations Survey scores. Results demonstrated that the audiovisual method did not significantly modify overall preoperative expectations compared to traditional verbal counseling. Significant changes were limited to only two survey items: anticipated range of motion and the ability to use stairs. No significant associations were found between the modification of expectations and patient demographics, including age, sex, and body mass index, or preoperative functional status as measured by the Knee Society Score and WOMAC index.
Conclusion: Supplemental audiovisual tools do not significantly enhance the alignment of patient expectations beyond what is achieved through traditional verbal communication. The surgeon-patient interview remains the most critical factor in managing preoperative expectations and ensuring postoperative satisfaction.
