Using a Digital Preoperative Plan to Manage Patient Expectations of Joint Replacement Surgery
Patient satisfaction is the ultimate goal of any orthopaedic surgeon performing a lower limb joint replacement. When the patient is shown to be satisfied with the results of their hip or knee arthroplasty; increased mobility, reduction in pain and consequent improvements in their quality of life, the surgeon can be satisfied that they have improved the life of their patient.
“Patient satisfaction is clearly an extremely important outcome. I routinely perform pre-operative planning for all arthroplasty procedures, including all primary cases, and it is the best method of reliably predicting the need for any special instrumentation or implant specification, aiming at better outcomes as well as facilitating pre-operative counselling to patients.”
A 2012 study of patient satisfaction that followed 4709 patients undergoing lower limb JR surgery over a 4 year period1 in a teaching hospital in Edinburgh, UK, concluded that “Three factors broadly determine the patient's overall satisfaction following lower limb joint arthroplasty; meeting preoperative expectations, achieving satisfactory pain relief, and a satisfactory hospital experience.”
In order to successfully meet a patient’s preoperative expectations, the surgeon needs to carefully explain the procedure and help them to understand the likely outcome during the consultation. A digital preoperative plan is a useful tool that can be used in face to face consultations with the patient for that purpose.
Ross Barker, Consultant Orthopaedic Surgeon at Nobles Hospital on the Isle of Man also uses his digital pre-operative plan to help the patient’s understand the surgery and to manage their expectations accordingly. He explains how he does this:
“Managing the patient’s expectations in hip arthroplasty is critical, especially with regards to leg length discrepancy management and offset and the digital plan enables me to explain the potential complications to the patient. The process starts with the first meeting, where I establish their expectations of a hip replacement on their lifestyle, sport etc. I use the digital plan as a visual aid to explain the potential complications in relation to LLD and offset and it helps to have the visual representation of the expected outcome to show them on the screen.”
Mr Barker believes that by explaining the procedure to his patients in this way, he is ultimately protecting himself from complaints or even legal action by helping the patient to understand the detailed steps and likely outcomes. He saves the plan to the PACS with his additional notes and also refers to it in his clinical notes as well.
Both Mr Charity and Mr Barker use Materialise OrthoView for their digital preoperative planning and templating.
1 What determines patient satisfaction with surgery? A prospective cohort study of 4709 patients following total joint replacement
D F Hamilton1, J V Lane2, P Gaston3, J T Patton3, D MacDonald1, A H R W Simpson1, C R Howie3