Establishing a hierarchy of total knee arthroplasty patients' goals and its congruity to health professionals' perceptions: a cohort study
Sascha Karunaratne, Ian Andrew Harris, Mark Horsley, Lyndal Trevena, Michael Solomon- General Medicine
- Surgery
Abstract
Background
To formulate a hierarchy of primary goals of patients prior to total knee arthroplasty (TKA) and evaluate the agreement between patients and health professionals regarding this hierarchy of patient goals.
Methods
The five most important goals for each of 110 consecutive patients booked for total knee arthroplasty between June and October 2019 were identified. Goals were grouped into themes and then a hierarchy formulated. This hierarchy was randomized and provided to 94 health professionals, including orthopaedic surgeons (n = 49), rheumatologists (n = 16), physiotherapists (n = 16) and general practitioners (n = 13). These health professionals ranked the provided goals based on their belief of what was most important to patients.
Results
Ten overarching goals were identified, with the five most important goals to patients being improving mobility, reducing knee pain, improving daily tasks, participating in social & leisure activities and regaining knee range of motion. Health professionals ranked these goals highly similar to patients with the exceptions being that health professionals ranked quality of life near the top of the hierarchy (much higher than patients) and ranked improving mobility in the bottom half (much lower than patients). Ranking of these goals was similar between each health professional group.
Conclusion
Pain and mobility are the most important goals to patients, with health professionals correctly identifying these as such. However, health professionals ranked quality of life higher, and mobility lower in the hierarchy than patients. This incongruity should be considered by health professionals when educating and communicating treatment outcomes.