Primary total hip arthroplasty: preoperative patients expectations and factors affecting them

The aim of this study was to carry out an in depth assessment of patient expectations prior to surgery in population undergoing primary THA and also assess the influence of demographic factors and pre-operative functions and the quality of life on patients expectations.Methods: This was a prospective cohort study of 1015 patients treated in our institution from November 2015 to October 2017. Patients received standard pre- operative preparation including consultation with a surgeon and information booklet. Patients completed the Hospital for Special Surgery (HSS) Hip Replace- ment expectation Survey along with the health (eQ5D) and the several functional questionnaires (OHS, HHS) on the day of admission.Results: Sixty three percent of the cohort were female, mean age 56,7 years (CI 95% 56-57,5), mean pre-operative expectations - 75,5% (CI 95% 74-77). Remove need for cane and improved ability to walk were the most important expectations. We found significant differences in the groups varying degrees of expectations with regard to quality of life (eQ5D), their preoperative functional status on OHS scale and pre-operative pain on VAS scale.Conclusion: This study suggests that patients have very high and sometimes unrealistic expectations regarding their improvements following THA even after detailed pre-operative consultation and education. Particular attention should be given to patients with concomitant orthopedic pathology, which requires additional diagnosis. The worse quality of life of patients and worse function in the joint lead to higher their preoperative expectations. Risk factors for increas- ing patient expectations also include employed and patients who are firstly operated. We suggest that in order to effectively manage patients expectations it is important to assess each patient individually according to his functional state before the operation and quality of life.