The fulfilment of patients' preoperative expectations and personal goals following periacetabular osteotomy.

Abstract

Patients electively undergo the treatment of symptomatic acetabular dysplasia by periacetabular osteotomy (PAO). Increasing evidence suggests that a patient's perception of success following orthopaedic surgery is influenced by their preoperative expectations. In response, the Hip Preservation Surgery Expectations Survey (HPSES) was developed to quantify improvement expected and received in domains of pain, function, and psychological well-being. This instrument has not yet been evaluated in a hip preservation sample postoperatively, consistent with a paucity in the literature regarding patient-derived goals. Therefore, the purpose of this study was to describe the fulfilment of expectations following PAO through the HPSES and collection of preoperative personal goals. Preoperatively and at 1-year, 80 participants undergoing PAO (mean age 27.5 ± 9.2 years, 98.8% female) completed the HPSES and/or personal goals surveys. A proportion was calculated as the amount of improvement received versus the amount of improvement expected. The average expectations proportional score was 0.97 with 51.6% achieving a proportional score ≥ 1.0. The average goals proportional score was 0.91 with 50.0% achieving a proportional score ≥ 1.0. Expectations and goals related to day-to-day function, social activity, routine exercise, and relieving stress and anxiety were met most often and correlated to improvement and satisfaction scores. Goals related to high-level physical activity and pregnancy were met less often. Higher preoperative expectations and less attainable goals were associated with lower fulfilment. The appraisal and management of appropriate and realistic goals hold considerable value in achieving patient-perceived satisfaction. PAO is successful in fulfilling expectations related to routine function, social activity, and psychological well-being.