TY - JOUR
T1 - The effects of patients’ expectations on surgery outcome in total hip and knee arthroplasty
T2 - a prognostic factor meta-analysis
AU - Laferton, Johannes A.C.
AU - Oeltjen, Lara
AU - Neubauer, Karolin
AU - Ebert, David D.
AU - Munder, Thomas
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Patients’ expectations are among the most frequently studied psychological prognostic factors in total knee and hip arthroplasty (TKA/THA). So far, however, evidence on the effect of patients’ preoperative expectations on surgery outcome is inconclusive. Heterogeneity of expectation constructs and the use of psychometrically not evaluated measurement instruments have constituted major obstacles for the integration of the current literature. Using a theory-based model of expectation constructs, this meta-analysis set out to disentangle the conflicting results in the current literature. Systematic literature searches yielded k = 46 studies (N = 10,465) that reported associations of preoperative expectations with postoperative pain, functioning and disability, and satisfaction. Random effects meta-analysis revealed a robust small association (r =.16; 95% CI.13,.19) between patients’ positive preoperative expectations and better postoperative outcomes. This effect did not differ between THA and TKA, different outcome categories and different follow-up periods. Studies using psychometrically evaluated expectation measures reported significantly higher effects (r =.19; 95% CI.16,.22). Whether this effect varies among different expectation constructs remains unclear. High-quality studies using validated, multidimensional expectation measures are needed to further understand the role of different expectation constructs in THA and TKA surgery.
AB - Patients’ expectations are among the most frequently studied psychological prognostic factors in total knee and hip arthroplasty (TKA/THA). So far, however, evidence on the effect of patients’ preoperative expectations on surgery outcome is inconclusive. Heterogeneity of expectation constructs and the use of psychometrically not evaluated measurement instruments have constituted major obstacles for the integration of the current literature. Using a theory-based model of expectation constructs, this meta-analysis set out to disentangle the conflicting results in the current literature. Systematic literature searches yielded k = 46 studies (N = 10,465) that reported associations of preoperative expectations with postoperative pain, functioning and disability, and satisfaction. Random effects meta-analysis revealed a robust small association (r =.16; 95% CI.13,.19) between patients’ positive preoperative expectations and better postoperative outcomes. This effect did not differ between THA and TKA, different outcome categories and different follow-up periods. Studies using psychometrically evaluated expectation measures reported significantly higher effects (r =.19; 95% CI.16,.22). Whether this effect varies among different expectation constructs remains unclear. High-quality studies using validated, multidimensional expectation measures are needed to further understand the role of different expectation constructs in THA and TKA surgery.
KW - arthroplasty
KW - joint replacement surgery
KW - meta-analysis
KW - osteoarthritis
KW - Patients’ expectations
KW - placebo effect
UR - http://www.scopus.com/inward/record.url?scp=85097844209&partnerID=8YFLogxK
U2 - 10.1080/17437199.2020.1854051
DO - 10.1080/17437199.2020.1854051
M3 - Article
C2 - 33228474
AN - SCOPUS:85097844209
SN - 1743-7199
VL - 16
SP - 50
EP - 66
JO - Health Psychology Review
JF - Health Psychology Review
IS - 1
ER -