PATIENTS EXPECTATIONS AND SATISFACTION WITH TOTAL HIP-ARTHROPLASTY

Although there have been many studies focusing on the increasingly imp ortant assessment of patients' satisfaction, few studies have specific ally addressed this issue for total hip arthroplasty (THA). The goals of this study were to measure patients' satisfaction with THA and to e valuate the relationships of expectations and outcome to patients' sat isfaction. A total of 180 patients were surveyed 2 to 3 years after TH A about their experiences with THA. Patients cited 45 different expect ations, which were grouped into five categories reflecting improvement in pain, walking, psychological state, essential activities, and none ssential 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 expe cted improvement in nonessential activities, and in patients who repor ted worse postoperative condition (as measured by self-assessment with the Hip Rating Questionnaire and the Medical Outcomes Study Short-for m General Health Survey). Patients were also asked how they came to TH A. Nearly 50% of patients were first referred to an orthopaedist by fa mily 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 satis faction with THA is a complex phenomenon, affected by expectations, ou tcome, and what patients know about the procedure from their community network. A better under standing of THA satisfaction will enable bett er future selection of patients and an additional dimension of outcome , both of which are important to patients and payers.