Patients control preferences and results in knee arthroplasty

G. Filardo, A. Roffi, G. Merli, T. Marcacci, F. Berti Ceroni, D. Raboni, E. Kon, M. Marcacci

Research output: Contribution to journalArticle

Abstract

Purpose: Patient engagement in a patient–physician decision-making process has been correlated with satisfaction and clinical outcomes. Aim of this study is to evaluate if patient control preference may also influence TKA results. Methods: One hundred and seventy-six patients (120w–56m, age 66 ± 9 years, BMI 28 ± 4) underwent TKA and were prospectively evaluated, before surgery and at 6 and 12 months. The preoperative assessment included the Control Preference Scale (CPS) and other scales measuring psychological aspects (STAI, BDI, TSK), as well as SF12 (physical and mental subscales) and the assessment of pain and function. Pain, function, and SF12 subscales were then used to evaluate the improvement at 6- and 12-month follow-up. Results: Pain, function, and SF12 scores improved at 6 and 12 months. CPS correlated with the outcome: pain and functional improvement at 6 months (p = 0.014; p = 0.003, respectively), patient function at 6 months (p = 0.022), improvement of SF12 physical subscale at 6 and 12 months (p = 0.027; p = 0.037, respectively), and satisfaction at 6 months (p = 0.033). Moreover, the multivariate analysis confirmed the importance of CPS regardless of other demographic, physical or psychological characteristics. Conclusion: In contrast with previous literature findings, this study shows that patients with more propensity for control presented lower improvements of pain and function than those more prone to rely on the physician making the decision. Physicians should be aware that the patient control preference may influence the treatment outcome and undertake measurements to optimize patient participation in the shared process to optimize the chances of TKA success. Level of evidence: IV.

Original languageEnglish
Pages (from-to)552-558
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume25
Issue number2
DOIs
Publication statusPublished - Feb 1 2017

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Knee Replacement Arthroplasties
Patient Preference
Patient Participation
Pain
Decision Making
Psychology
Physicians
Pain Measurement
Multivariate Analysis
Demography

Keywords

  • CPS
  • Knee
  • Share decision-making
  • TKA
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Filardo, G., Roffi, A., Merli, G., Marcacci, T., Berti Ceroni, F., Raboni, D., ... Marcacci, M. (2017). Patients control preferences and results in knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 25(2), 552-558. https://doi.org/10.1007/s00167-016-4405-6

Patients control preferences and results in knee arthroplasty. / Filardo, G.; Roffi, A.; Merli, G.; Marcacci, T.; Berti Ceroni, F.; Raboni, D.; Kon, E.; Marcacci, M.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 25, No. 2, 01.02.2017, p. 552-558.

Research output: Contribution to journalArticle

Filardo, G, Roffi, A, Merli, G, Marcacci, T, Berti Ceroni, F, Raboni, D, Kon, E & Marcacci, M 2017, 'Patients control preferences and results in knee arthroplasty', Knee Surgery, Sports Traumatology, Arthroscopy, vol. 25, no. 2, pp. 552-558. https://doi.org/10.1007/s00167-016-4405-6
Filardo G, Roffi A, Merli G, Marcacci T, Berti Ceroni F, Raboni D et al. Patients control preferences and results in knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy. 2017 Feb 1;25(2):552-558. https://doi.org/10.1007/s00167-016-4405-6
Filardo, G. ; Roffi, A. ; Merli, G. ; Marcacci, T. ; Berti Ceroni, F. ; Raboni, D. ; Kon, E. ; Marcacci, M. / Patients control preferences and results in knee arthroplasty. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2017 ; Vol. 25, No. 2. pp. 552-558.
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AU - Kon, E.

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AB - Purpose: Patient engagement in a patient–physician decision-making process has been correlated with satisfaction and clinical outcomes. Aim of this study is to evaluate if patient control preference may also influence TKA results. Methods: One hundred and seventy-six patients (120w–56m, age 66 ± 9 years, BMI 28 ± 4) underwent TKA and were prospectively evaluated, before surgery and at 6 and 12 months. The preoperative assessment included the Control Preference Scale (CPS) and other scales measuring psychological aspects (STAI, BDI, TSK), as well as SF12 (physical and mental subscales) and the assessment of pain and function. Pain, function, and SF12 subscales were then used to evaluate the improvement at 6- and 12-month follow-up. Results: Pain, function, and SF12 scores improved at 6 and 12 months. CPS correlated with the outcome: pain and functional improvement at 6 months (p = 0.014; p = 0.003, respectively), patient function at 6 months (p = 0.022), improvement of SF12 physical subscale at 6 and 12 months (p = 0.027; p = 0.037, respectively), and satisfaction at 6 months (p = 0.033). Moreover, the multivariate analysis confirmed the importance of CPS regardless of other demographic, physical or psychological characteristics. Conclusion: In contrast with previous literature findings, this study shows that patients with more propensity for control presented lower improvements of pain and function than those more prone to rely on the physician making the decision. Physicians should be aware that the patient control preference may influence the treatment outcome and undertake measurements to optimize patient participation in the shared process to optimize the chances of TKA success. Level of evidence: IV.

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