The preoperative education on realistic expectations does not continually improve patients' satisfaction after total knee arthroplasty? A randomized controlled trial with serial assessment
Bibliographic record
Abstract
PURPOSE: This study aimed to determine whether preoperative education using an additional module based on realistic expectations continuously improves patient satisfaction after total knee arthroplasty (TKA), particularly in highly centrally sensitized patients. METHODS: This was a single-center, randomized controlled trial. Initially, 172 patients who underwent TKA were enroled. The patients were randomly assigned to the intervention (additional module on realistic expectations) or control (standard preoperative education) groups. Prospective serial assessments were conducted at postoperative 3-months, 6-months, 1-year and 2-years. The primary outcome was patient satisfaction, and the secondary outcomes were Short Form (SF)-36 and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Subgroup analysis was performed using central sensitization inventory (CSI) scores. RESULTS: At 1-year, the mean satisfaction score was higher in the intervention group than in the control group (4.2 ± 0.9 vs. 3.9 ± 0.9, p = 0.01); however, it was not different at 2-years. Significant differences were noted in the SF-36 physical and mental (p = 0.02 and p = 0.02, respectively) and WOMAC pain and stiffness at 6-months (p = 0.04 and p = 0.04, respectively). At 1-year, a significant difference was noted in WOMAC pain (p = 0.05); however, no difference was noted at 2-years. The satisfaction score in the top 25% CSI group at 1-year was 4.6 ± 0.6 in the intervention group and 3.8 ± 0.8 in the control group (p = 0.01). However, preoperative CSI did not affect satisfaction and clinical scores at 2 years. CONCLUSIONS: Preoperative education on realistic expectations after TKA showed effects on secondary outcomes at postoperative 6-months, with the effect on WOMAC pain persisting at postoperative 1-year. However, the effect on patient satisfaction only appeared at 1-year postoperatively. Differences between the preoperative CSI groups were observed up to postoperative 1-year but not at postoperative 2-years. LEVEL OF EVIDENCE: Level I.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".