Abstract
PurposeThe aim of this prospective study was to understand the fear and apprehension factors that play on patient’s mind before total knee arthroplasty.MethodsThis retrospective cohort study included 500 consecutive patients (375 females and 125 males) who were scheduled to undergo total knee arthroplasty the next day. The patients were asked to list the most important fear in their mind regarding the operation in descending order of importance. They were given a questionnaire form which contained several capture points, including age, gender, educational background, occupation, and provision of help at home. Preoperative pain was measured by using the visual analog score, and its influence on the patients’ fear and apprehension factors was also measured.ResultsIn this study, 58% of patients (50 males, 40%; 240 females, 64%) were fearful of the pain that they would experience after surgery and during the postoperative physiotherapy. The female patients showed more fear of pain than their male counterparts (P < 0.05). 18% of the patients (40 males, 32%; 50 females, 13%) listed whether they will be able to walk and perform activities of daily living after surgery as the most important fear. The male patients had more fear of returning to normal walking (P < 0.05). 20% of the patients (30 males, 24%; 70 females, 19%) were fearful about getting adequate home help after discharge from hospital (P > 0.05). 4% of patients were concerned about withstanding such a major operation. There was no difference between male and female patients (P > 0.05).ConclusionThe majority of the patients experience apprehension of pain in the perioperative period of TKA. Preoperative counseling benefits pain management by alleviating the patient’s concerns about the fear of postoperative pain and apprehension of returning to normal walking.
Highlights
A large population-based prevalence surveys showed that, with increased life expectancy and obesity, the incidences of the degenerative knee diseases stood at around 10% [1]
58% (50 males and 240 females) reported apprehension of the pain related to the Total knee arthroplasty (TKA) and physiotherapy; 18% of the patients (40 males and 50 females) listed whether they would be able to walk and do activities of daily living (ADL) after TKA, which was the most important fear; 20% (30 males and 70 females) were fearful of whether they would get adequate home help once they get discharged from hospital and 4% (5 males and 15 females) concerned whether they would be able to withstand such a major operation (Figs. 1 and 2)
Majority of the patients in our cohort were concerned about the postoperative pain, and the female patients showed more fear about postoperative pain than
Summary
A large population-based prevalence surveys showed that, with increased life expectancy and obesity, the incidences of the degenerative knee diseases stood at around 10% [1]. Total knee arthroplasty (TKA) is one of the most successful surgeries in modern-day orthopedics, Multiple studies have shown that the TKA could markedly improve patients’ knee pain, physical function, and health-related quality of life [1, 2]. A sizable number of patients refuse to undergo TKA due to certain factors, including perioperative fear and apprehension of pain, other anxiety, age, gender, area of residence, education level, occupation,. Understanding patient’s decision making has potential benefits to improve preoperative counselling, patient satisfaction and financial constraints. The aim of this prospective study was to understand the fear and apprehension factors that play on patient’s mind before TKA
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