It’s time to get realistic about what your knee replacement will deliver, says Jim Newman.
Earlier this year, a study was published that looked at the effect of expectation on knee replacement patient satisfaction. The paper concluded that the more realistic the education ahead of the operation, the more satisfied patients were afterwards.
You might think this is rather obvious. If you tell me I’ve won £1,000 in a prize draw and then revise that down to £100, I’m likely to feel cheated, even though I’m £100 better off than I was. If you had told me I had won £100 from the outset I would have been delighted.
But expectations really matter in knee replacements, and expectation management is extremely important from a surgeon’s perspective. Tell a patient that their post-replacement knee will feel as it did when they were 18 and they are going to be disappointed. It won’t. it can’t. A total knee replacement involves removing the ACL (anterior cruciate ligament) so how can it possibly feel the same?
Inflating expectations is doubly frustrating because a knee replacement can frequently be transformative. It’s just not designed to create a ‘normal’ knee.
A knee replacement is a pain relieving operation. That’s its prime function and it does it very well. It will also restore a significant degree of function. A partial (as opposed to a total) knee replacement will do that even more effectively which is why I’ll usually be considerably more optimistic when discussing expectations for a partial replacement with patients.
But whichever procedure you undergo, many patients find their knee replacement is a huge improvement. Yes, total knee replacement patients in particular can expect a little swelling now and then. You may still expect a degree of pain at the end of an active day. Yet if you’re living with osteoarthritis, I imagine you would gladly accept that over what you have now.
As the paper suggested, the more realistic we are about the outcome of your knee replacement, the happier you are likely to feel about it.
Consultant Knee Surgeon at the Yorkshire Knee Clinic
“Mr Newman? He’s a genius in my eyes.”
Glen Jackson, YKC patient
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