How well does information and education given before hip or knee replacement surgery improve recovery?
To answer this question, scientists analysed 9 studies testing over 750 people, 58 to 71 years old. These people had hip or knee replacement surgery because of arthritis, an accident or another reason. Some people received written information, discussed the surgery with a health professional, watched a video or received no information. These studies provide the best evidence we have today.
Why might education before surgery help with recovery?
Often when other treatments do not work to provide relief in diseases such as osteoarthritis, hip or knee replacement surgery may be necessary. But, surgery can be stressful - emotionally and physically. It is thought that people who receive information and are educated about their surgery and recovery before their surgery, will be less anxious, be able to handle pain better and not have to stay in hospital long.
Does it improve recovery?
Studies showed that people with or without education before surgery had about the same amount of pain, were just as satisfied with their surgery, started walking and climbing stairs at about the same time after surgery and stayed in hospital for about the same amount of time. One study did show that in people who could not move well and didn't have support, the ones that had education before surgery did not stay in hospital as long as those who did not have education.
Three studies showed that people with education before surgery were less anxious before surgery, but two other studies found that anxiety was the same. Four studies showed that people with or without education before surgery had about the same amount of anxiety after surgery.
One study showed that people with education before surgery had fewer complications, but another study showed people had about the same amount. Whether it improved the risk of blood clots or Deep Vein Thrombosis (DVT) was not tested.
What is the bottom line?
There is "Silver" level evidence that education before surgery does not seem to decrease pain, improve function or decrease the number of days in hospital after surgery. But education before surgery may decrease anxiety before surgery. Education and information that is individually geared to a person and given before surgery may improve recovery in people who need support or do not move well.
Future research should find out which people need education before surgery, what type of education (pamphlets, videos, etc.) works best and whether education before and after surgery is better.