Abstract
Purpose: Factors influencing patient willingness to undergo elective surgery are poorly understood.
Method: We prospectively evaluated patient concerns prior to surgical consultation for elective spinal, hip, knee, shoulder/elbow (S/E), or foot/ankle (F/A) conditions. Patients were surveyed for demographic data, SF 36 quality of life (QOL) scores and asked to report their greatest concern about considering surgery for their condition, as well as their willingness to undergo surgery if it was offered to them by their treating surgeon.
Results: In our prospective cohort of 743 patients, 364 (51%) were male and 293 (39 %) were evaluated for a spine condition, 74 (10 %) hip, 192 (26 %) knee, 69 (9 %) S/E, and 115 (16 %) F/A. Mean QOL scores were similar for patients across specialities. The top three greatest concerns for undergoing elective musculoskeletal surgery were potential complications (20%), effectiveness (15%) and recovery time (15%) of surgery. When categorized by specialty, concern of surgical complications was the most prevalent in spine (23%) and F/A patients (30%). However, patients were most commonly unsure of risks associated with their respective subspecialty surgery (spine – 56%; hip – 53%; knee – 44%; S/E – 48% and F/A – 33%). The majority of hip patients (89%) perceived a high success rate for hip surgery, while 65% of spine patients where unsure of the success of spine surgery. Patient willingness to undergo surgery was greatest for hip (84%), knee (78%), and S/E (82%) surgery and least for spine (68%) and F/A surgery (74%).
Conclusion: Although patient willingness to consider surgery is clearly a multifactorial decision, patient perception of surgical risk or success prior to surgical consultation are significant factors.
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