Patient preoperative expectations of total hip replacement in European orthopedic centers

Nicola Hobbs*, Diane Dixon, Susan Rasmussen, Andy Judge, Karsten E. Dreinhöfer, Klaus Peter Günther, Paul Dieppe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Objective Patient expectations have been identified as a factor that may account for individual differences in recovery after total hip replacement (THR) surgery. However, patient expectations have not been studied within a valid theoretical framework. This study employed the World Health Organization's model of health, the International Classification of Functioning, Disability and Health (ICF), to classify the content of preoperative patient expectations of THR. Methods A European cohort of 1,108 patients preoperatively reported 2 types of expectations. Patients reported what they anticipated surgery would enable them to do that they needed to be able to do ("need" expectation), and what they would like to be able to do ("desire" expectation) in a year's time. Free-text responses were independently classified by 2 researchers to 1 or more of the ICF constructs of impairment, activity limitation, and participation restriction. Results Interrater reliability was high (κ = ≥0.87). All patient expectations were classified to the ICF constructs. Less than 5% of patient expectations were identified as impairment, 58% of "need" expectations were identified as activity limitations, and 45% of "desire" expectations were identified as activity limitations and participation restrictions combined. Conclusion The ICF is a suitable theoretical framework to study patient expectations of THR. THR targets impairment; however, few patient expectations were classified to the ICF definition of impairment. The majority of patient expectations were classified as activity limitation or a combination of activity limitation and participation restriction. Therefore, patient expectations of surgery focus on recovering valued activities rather than reversal of bodily impairments.

Original languageEnglish
Pages (from-to)1521-1527
Number of pages7
JournalArthritis Care and Research
Issue number11
Early online date27 Oct 2011
Publication statusPublished - Nov 2011
Externally publishedYes

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