Abstract

BackgroundThe Hospital for Special Surgery Hip Replacement Expectations Survey (HSS-THRES) and Knee Replacement Expectations Survey (HSS-TKRES) are widely used tools developed to assess patients’ preoperative expectations for total hip and knee arthroplasty. This study aimed to translate and adapt the HSS-THRES and HSS-TKRES into Chinese versions (SC-THRES/TKRES) and evaluate their psychometric properties in patients with osteoarthritis (OA) and ankylosing spondylitis (AS).MethodsPatients scheduled for total hip (104 hip OA and 51 AS) or knee replacements (101 knee OA) were recruited in this study. Confirmatory Factor Analysis (CFA) was used to evaluate structural validity. The internal consistency was assessed by the Cronbach’s α coefficient. The intraclass correlation coefficient (ICC) was used to assess test-retest reliability. The construct validity was analyzed by evaluating the correlations between SC-THRES/TKRES and the Expectation WOMAC. The correlations with the Expectation WOMAC were tested against our hypotheses. We additionally compared preoperative expectations of AS patients to those of hip OA patients.ResultsThe results of CFA for the SC-THRES and SC-TKRES demonstrated good fit. The results for the SC-THRES/TKRES revealed good test-retest reliability and good internal consistency (AS: ICC = 0.893, Cronbach’s α = 0.815; hip OA: ICC = 0.878, Cronbach’s α = 0.814; knee OA: ICC = 0.806, Cronbach’s α = 0.808). The correlations between the SC-THRES/TKRES and the Expectation WOMAC were moderate (0.541 for AS, 0.490 for hip OA and 0.465 for knee OA), which were consistent with the hypotheses.ConclusionThe SC-THRES/TKRES are reliable, valid for the evaluation of Chinese patients with OA and AS undergoing total hip and knee arthroplasty. The surveys can be used as part of preoperative assessments. Meanwhile, additional research is needed to replicate these findings and to assess the content validity in a larger sample.

Highlights

  • The Hospital for Special Surgery Hip Replacement Expectations Survey (HSS-THRES) and Knee Replacement Expectations Survey (HSS-TKRES) are widely used tools developed to assess patients’ preoperative expectations for total hip and knee arthroplasty

  • Sociodemographic and clinical characteristics In total, 270 patients were recruited into the registry

  • All the patients completed the questionnaires without any difficulties

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Summary

Introduction

The Hospital for Special Surgery Hip Replacement Expectations Survey (HSS-THRES) and Knee Replacement Expectations Survey (HSS-TKRES) are widely used tools developed to assess patients’ preoperative expectations for total hip and knee arthroplasty. Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are extremely effective in reducing pain and restoring function in patients with end-stage osteoarthritis (OA) and ankylosing spondylitis (AS) [3,4,5]. Previous researches have indicated that fulfillment of preoperative expectations was one of the most important factors affecting satisfaction and was a large contributor to functional outcomes [8,9,10,11,12,13]. Several studies have shown that compared with the actual ability after surgery, preoperative expectations were higher [11, 18]. More disabled patients often have higher preoperative expectations than their surgeons [19, 20]. Patients requiring TJA often have overly optimistic preoperative expectations, and many of them do not trust their surgeons. There are no standard methods to assess expectations based on patient-derived measures

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