The Effect of Preoperative Information and Education on the Clinical Outcome of Total Hip Arthroplasty: A Prospective, Randomized Trial

术前信息和教育对全髋关节置换术临床结果的影响:一项前瞻性随机试验

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Abstract

Introduction Preoperative patient information and education is an essential aspect of modern surgical care, particularly for patients undergoing total hip arthroplasty (THA). This prospective, randomized trial aimed to assess the effects of structured preoperative education and information on clinical outcomes in patients undergoing THA. Materials and methods A total of 102 patients were randomized into two groups: the intervention group (n = 51) receiving standardized preoperative information and education, and the control group (n = 51) receiving standard preoperative care without a formal educational component. Postoperative outcomes, including functionality, mobility, length of hospital stay (LOS), patient satisfaction, health-related quality of life, anxiety, depression and fear for surgery, were compared between the two groups. Results Both groups were comparable in baseline characteristics, including age, sex, body mass index (BMI), smoking status and alcohol consumption. The mean age was 66.3 years, mean BMI was 29.05 and 70.6% of participants were female. Patients in the intervention group had a shorter mean hospital stay (mean 4.9 days vs. 6.2 days, p=0.031). Mean preoperative modified Harris Hip Score (mHHS) was similar between the two groups (p = 0.866). However, one month postoperatively, mHHS was significantly higher in the intervention group compared to controls (74.06 versus 67.81, p = 0.046). The absolute change in European Quality of Life 5 Dimensions 5 Level (EQ-5D-5L) Index and EQ-5D-5L Visual Analogue Scale (VAS) score before and after THA was statistically significant (p = 0.021 and p = 0.042). Preoperative and postoperative depression was significantly lower in the intervention group, one day preoperatively, one day before discharge and one month postoperatively, as shown by the Hospital Anxiety and Depression Scale (HADS) (p = 0.026, p = 0.027 and p = 0.018 respectively). Conclusions This prospective, randomized trial demonstrated that preoperative education and information significantly improve clinical outcomes, duration of hospitalization, health-related quality of life and postoperative anxiety in patients undergoing THA. These findings underline the importance of incorporating structured educational programs into preoperative care protocols prior to THA for enhancing patient recovery and optimizing postoperative results.

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