A Trial to Establish Realistic Patient Expectations of Total Knee Replacement
Condition: Osteoarthritis
MeSH terms: Osteoarthritis
Study type: Interventional

Summary: 
      Patients from the Joint Replacement Institute scheduled to undergo primary total knee
      replacement surgery (TKR) will be invited to participate at the Pre Admission Clinic (PAC),
      University Hospital, London Health Sciences Centre. Baseline questionnaires of preoperative
      measures and demographic information and a cost analysis will be explored at the PAC for each
      patient. Patients will be randomized with the treatment group receiving access to a
      web-based, e-learning intervention. Postoperatively all patients will be asked to complete
      questionnaires at 6 weeks, 3 months and 1 year after their TKR surgery.

      Objectives

      The first primary objective is to compare the effect of two methods of providing patient
      education on expectations of surgical outcome in total knee replacement (TKR) patients.

      The second objective is to compare the effect of two methods of providing patient education
      on satisfaction with surgical outcome in TKR patients.

      The intervention of interest is an e-learning education program that spans both the
      preoperative and postoperative time period. The control condition will be the current method
      of patient education provided at the hospital study site.

      Hypothesis: Objective One

      More change in patient expectations will occur between preoperative and one year
      postoperative in the e-learning educational intervention group.

      Hypothesis: Objective Two

      More change in patient satisfaction will occur between preoperative and one year
      postoperative in the e-learning educational intervention group.
    

Detailed description: 
      This will be a single centre prospective experimental study, involving seven orthopaedic
      surgeons and their patients undergoing total knee replacement (TKR). A consecutive sample of
      elective primary TKR patients will be invited to participate from London Health Sciences
      Centre, University Hospital, London, Ontario, Canada. Additionally, patient hospital charts
      will be accessed to establish the concordance between co-morbidities recorded in patient
      history and self-report measures of co-morbidities.

      Interested patients will be randomized into one of two groups. Group 1 (intervention) will
      receive the e-learning educational intervention in addition to the current method of patient
      education. It will commence at the pre-admission clinic and continue to the study end-point
      of 1-year postoperative. Group 2 (control) will receive the current, existing method utilized
      by each of the seven orthopaedic surgeons for their patient education. At pre-admission,
      patients are provided a 31 page hard copy of My Guide to Total Knee Joint Replacement
      (Revised January, 2008) and they are made aware of an electronic copy of this document
      available at the following website: http://www.jointreplacementinstitute.com/patients.html

      The assumption is that patients can and will read this document to educate themselves about
      their TKR surgery. The interactive e-learning patient education intervention extends beyond
      simple accessibility to information and includes interactive features. The intervention spans
      surgery and rehabilitation aftercare with patients undergoing TKR. Measurements will take
      place at pre-admission before any preoperative education takes place and at 6 weeks, 3 months
      and 1 year after TKR surgery. Patients will have the option of completing questionnaires
      online using Empower or hard copy sent by mail. They will also receive reminders by email or
      phone about completing the questionnaires.
    

Intervention name(s): Patient e-Learning educational tool
Intervention type(s): Other
Intervention description(s): Web based site with videos of TKR surgical animation, demonstrations of exercises and activities following surgery and conversations with surgeons, physiotherapist, occupational therapist and patients.
Other intervention name(s): NewKnees.ca
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Primary Total Knee Arthroplasty; Patient Expectations; Patient Satisfaction; Patient Education; e-Learning