The Orthopaedic Gut Feeling.

Melman, W.P.R. (2013) The Orthopaedic Gut Feeling. thesis, Medicine.

Text MelmanWPR.pdf Restricted to Registered users only Download (1MB)

Abstract

Background: Total knee and total hip arthroplasties (TKA/THA) are highly effective procedures in improving the quality of life. Nevertheless, some patients are not satisfied with the end result, for instance because of chronic pain or physical limitations. Within this group of patients there is not always a good explanation for the dissatisfaction. Psychological factors like depression and unfavorable pain coping, which have lately been related to the outcome of THA/TKA, may play a role. However, it is not known how these factors should be assessed and interpreted in contemporary orthopaedic practice. Orthopaedic surgeons may have a gut feeling about the ultimate success of the operation which takes these factors into account. This “Orthopaedic Gut Feeling” (OGF) could then be of predictive value concerning the outcome of the operation. Aim: We wanted to see if the Orthopaedic Gut Feeling, 1. incorporates unfavorable psychological factors and 2, if it is predictive for the outcome of arthroplasty surgery. Method: We studied 79 THA/TKA patients prospectively. Pre-operatively, five orthopaedic surgeons rated expected subjective patient satisfaction with the outcome of the THA/TKA on a VAS scale (the OGF). This OGF was correlated with the Hospital Anxiety and Depression Scale (HADS) and Pain Coping and Cognition List (PCCL) questionnaires, filled in by patients. Also, we investigated agreement between the OGF and the patient satisfaction, at a minimum of six months after the operation. Finally we correlated the OGF with patient reported outcome measures (PROM’s), also at a minimum of six months post-operatively. Results: The Orthopaedic Gut Feeling correlated significantly with the predisposition to catastrophize pain, r = -0.282. There was bad agreement between the Orthopaedic Gut Feeling and post-operative patient satisfaction. There was no correlation between the Orthopaedic Gut Feeling and PROM’s. Conclusion/Discussion: The OGF shows only a weak correlation with catastrophizing and has no value in predicting the outcome of TKA/THA surgery. The value of these findings is greatly reduced by limitations of the study, like the use of an unvalidated VAS score to objectify the OGF. More research is needed to determine the exact value of the OGF.

Item Type:	Thesis (Thesis)
Supervisor name:	Jonbergen, Dr. H. van
Supervisor name:	Henkus, Drs. H.E. and HAGA Ziekenhuis and Orthopedie
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:45
Last Modified:	25 Jun 2020 10:45
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/684

Actions (login required)

View Item