Meeting preoperative expectations is known to be of major influence on postoperative satisfaction after total knee arthroplasty (TKA). Improved management of expectation, resulting in more realistic expectations can potentially lead to higher postoperative satisfaction. The objective of this study was to assess the effect of an additional preoperative education module, addressing realistic expectations for long-term functional recovery, on postoperative satisfaction and expectation fulfilment. In total, 204 primary TKA patients with osteoarthritis were enrolled in this randomized controlled trial (RCT). Patients were allocated to either usual preoperative education (control group) or usual education plus an additional module on realistic expectations (intervention group). Primary outcome was being very satisfied (numerical rating scale for satisfaction ≥ 8) with the treatment result at 12 months' follow-up. Other outcomes were change in preoperative expectations and postoperative expectation fulfilment.Aims
Methods
Most patients (95%) with fibular hemimelia have
an absent anterior cruciate ligament (ACL). The purpose of this study
was to assess the long-term outcome of such patients with respect
to pain and knee function. We performed a retrospective review of
patients with fibular hemimelia and associated ACL deficiency previously
treated at our institution. Of a possible 66 patients, 23 were sent
the Musculoskeletal Outcomes Data Evaluation and Management System
(MODEMS) questionnaire and Lysholm knee score to complete. In all,
11 patients completed the MODEMS and nine completed the Lysholm
score questionnaire. Their mean age was 37 years (27 to 57) at review.
Five patients had undergone an ipsilateral Symes amputation. There
was no significant difference in any subsections of the Short-Form
36 scores of our patients compared with age-matched controls. The
mean Lysholm knee score was 90.2 (82 to 100). A slight limp was
reported in six patients. No patients had episodes of locking of the
knee or required a supportive device for walking. Four had occasional
instability with sporting activities. These results suggest that patients with fibular hemimelia and
ACL deficiency can live active lives with a similar health status
to age-matched controls.
