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Rheumatoid arthritis patients have low expectations after knee replacement surgery
Date:11/5/2011

ectations preoperatively. So, if you don't expect much and you don't get much, you could be pretty happy," said Dr. Mandl. "You might have a person who says, 'I would love to have this surgery and be able to get up and walk to the bathroom without pain.' And when they have their surgery, they can get up and walk to the bathroom without pain, but maybe because that is all they expected, they kind of give up after that. They might not be optimizing their postoperative physical therapy."

"Our rheumatoid arthritis patients have just come along extraordinarily in the last decade with, first, the widespread use of traditional medications and now the more widespread use of the potent biological medications," said Susan Goodman, M.D., a rheumatologist at Special Surgery. "What we can do as doctors is ensure that we educate our patients properly. In the past, our rheumatoid arthritis patients didn't do as well as other patients and those expectations were realistic, but I think times are changing. RA patients might think 'oh, I'm never going to have great function, why am I pushing myself?' That would be shortchanging themselves. Doctors should explain to RA patients that they should expect good outcomes."

According to Dr. Mandl, doctors should assess patients' preoperative expectations. "If they are concerned that patient's expectations are not in line with what they would predict, then doctors should recalibrate what the patient is hoping for, so that they can get the best result they can," she said.

Dr. Mandl says the study also makes her wonder if patients with RA are not choosing to have surgery because they don't think it will make a difference.

RA is an autoimmune disease that causes joint swelling, pain and fatigue among other symptoms. Osteoarthritis is caused by the normal wear and tear of the aging process; it can be encouraged by a high impact injury or obesity.


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Contact: Phyllis Fisher
phyllis.fisher@gmail.com
212-606-1197
Hospital for Special Surgery
Source:Eurekalert

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