Dr. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from URL Pharmaceuticals, Savient, Takeda, Novartis, and Abbott; research and travel grants from Takeda, Savient, Wyeth, Amgen, the Arthritis Foundation, University of Minnesota, Cochrane Library, and Department of Veterans Affairs; and investigator-initiator grants from Allergan, Savient, and Takeda.
Informed Consent for Arthroplasty
Patient understanding and satisfaction in informed consent for total knee arthroplasty: A randomized study†
Article first published online: 29 JUN 2011
Copyright © 2011 by the American College of Rheumatology
Arthritis Care & Research
Volume 63, Issue 7, pages 1048–1054, July 2011
How to Cite
Johnson, M. R., Singh, J. A., Stewart, T. and Gioe, T. J. (2011), Patient understanding and satisfaction in informed consent for total knee arthroplasty: A randomized study. Arthritis Care Res, 63: 1048–1054. doi: 10.1002/acr.20475
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US Government.
- Issue published online: 29 JUN 2011
- Article first published online: 29 JUN 2011
- Accepted manuscript online: 11 APR 2011 01:08PM EST
- Manuscript Accepted: 17 MAR 2011
- Manuscript Received: 17 DEC 2010
- Minneapolis VA Medical Center
- Birmingham VA Medical Center
Informed consent is a critical component of all surgical procedures, but patients' understanding and recall of the potential risks/benefits is poor. We hypothesized that utilization of multiple standardized education modalities in the informed consent process would allow for better retention and a more informed patient.
A total of 151 patients undergoing primary total knee arthroplasty (TKA) were randomized to 3 groups: group 1 received standardized informed consent and a paper handout detailing the risks/benefits of TKA; group 2 received standardized informed consent, a paper handout, and a video discussing the risks/benefits of TKA; and group 3 followed the same process as group 2 plus formal nurse education. All patients completed a 15-item questionnaire (risks, indications, and expectations) immediately following this consent process on the morning of surgery and 6 weeks postoperatively. We used t-test and analysis of variance for data analyses.
There was no difference (P = 0.79) in satisfaction with the consent process between the 3 groups; 92–97% of the patients rated the consent process as good to excellent at all time points. The number of correct answers did not differ significantly between the groups at any time period (P = 0.31–0.81). Scores dropped significantly (P = 0.004) from preoperatively to the 6-week postoperative visit in all groups combined. A higher level of satisfaction with the process was reflected in higher scores preoperatively in all groups (P = 0.028).
Preoperatively, patients satisfied with the consent process may have better recall of risks/benefits and expectations of surgery. Neither retention nor satisfaction was influenced by reinforcement methods, such as video or nurse education; they may therefore be unnecessary.