Patients contemplating a total joint replacement are often times facing life altering changes in their lives. They have reached a point that the level of pain and discomfort they suffer from outweighs the risks or fears surrounding the surgery.

Most patients turn to their physicians to help them navigate the process of surgery. Surgeons performing total joint replacements can help improve patient satisfaction through a myriad of factors including pre-operative education, effective pain control and post-operative care initiatives.

Before proceeding with joint replacement surgery, physicians should take the time to thoroughly educate the patients on the realistic expectations, risks, and outcomes of the surgery.

The better informed a patient is the less anxious and fearful they will be about the procedure. Physicians should be prepared to repeat the information in a variety of formats until the patient completely understands and has all their questions answered.

Part of the pre-operative education should be listening to the patients questions and concerns and answering honestly without reservation.

Physicians should encourage patients to have their support group of family or friends attend the pre-operative appointment so that more people are hearing the same information.

Another option that can be provided to patients would be reliable online resources for them to research their potential surgery. Finally, the surgeon can offer for patients to speak with past surgical patients who can then give them an idea of what to expect based on their own personal experiences.

This may help alleviate some of the mystery surrounding their surgery.

Another key factor in patient satisfaction is actively managing the post-operative pain. Total joint replacements are large surgeries involving a great deal of trauma to the body.

Pre-medicating or using intraoperative multi-modality pain management techniques may help patients have more success after surgery. Narcotic pain medication is the most commonly used pain control method.

Common side effects of narcotics are nausea, constipation and lethargy. A key component to recovery after a joint replacement is early and frequent movement of the new joint.

The side effects of narcotics can be a deterrent for joint replacement patients to exercise the new joint. Lack of movement can lead to blood clots as well as disuse atrophy which are counterproductive to patient success.

Although narcotics are needed for pain control, patients should be well informed as to their side effects and addictive qualities prior to the surgery.

By thoroughly articulating to the patients prior to surgery the possible side effects of the needed post-operative medications it may help them understand and stay on task while rehabilitating the new joint.

Finally, post-operative care should be discussed and arranged prior to the surgical procedure. By having the patients’ family or support team present at the pre-operative appointment, these arrangements can be discussed with all that may be involved.

Many patients may need a rehabilitation facility, home, or outpatient physical therapy. Having these services already established before surgery will allow the patient to focus on recovery and have more peace of mind after the procedure.

Orthopedic surgeons should remember that this is a very important day in the life of the patient and their family. They should keep in mind that patients may be anxious, have other health issues to factor in and that most of them are not knowledgeable about the medical specifics of their procedure.

Communication should be thorough and simplified for easy understanding. Each patient and family is as different as each surgery. If surgeons use a combination of thorough pre and post operative education along with effective pain control it will likely result in much higher patient satisfaction.

2016 Scholarship Finalist

Kira T

New Port Richey, Florida

The final question on the application was an essay question.
The essay question was:

How can orthopedic surgeons doing hip and knee replacement surgery improve patient satisfaction?

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