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01-12-2021 | Knee-TEP | Research article

Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study

Authors: Anna M. Anderson, Christine Comer, Toby O. Smith, Benjamin T. Drew, Hemant Pandit, Deborah Antcliff, Anthony C. Redmond, Gretl A. McHugh

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Over 90,000 total knee replacement (TKR) procedures are performed annually in the United Kingdom (UK). Patients awaiting TKR face long delays whilst enduring severe pain and functional limitations. Almost 20% of patients who undergo TKR are not satisfied post-operatively. Optimising pre-operative TKR education and prehabilitation could help improve patient outcomes pre- and post-operatively; however, current pre-operative TKR care varies widely. Definitive evidence on the optimal content and delivery of pre-operative TKR care is lacking. This study aimed to develop evidence- and consensus-based recommendations on pre-operative TKR education and prehabilitation.

Methods

A UK-based, three-round, online modified Delphi study was conducted with a 60-member expert panel. All panellists had experience of TKR services as patients (n = 30) or professionals (n = 30). Round 1 included initial recommendations developed from a mixed methods rapid review. Panellists rated the importance of each item on a five-point Likert scale. Panellists could also suggest additional items in Round 1. Rounds 2 and 3 included all items from Round 1, new items suggested in Round 1 and charts summarising panellists’ importance ratings from the preceding round. Free-text responses were analysed using content analysis. Quantitative data were analysed descriptively. All items rated as ‘Important’ or ‘Very important’ by at least 70% of all respondents in Round 3 were included in the final set of recommendations.

Results

Fifty-five panellists (92%) (patients n = 26; professionals n = 29) completed Round 3. Eighty-six recommendation items were included in Round 1. Fifteen new items were added in Round 2. Rounds 2 and 3 therefore included 101 items. Seventy-seven of these reached consensus in Round 3. Six items reached consensus amongst patient or professional panellists only in Round 3. The final set of recommendations comprises 34 education topics, 18 education delivery approaches, 10 exercise types, 13 exercise delivery approaches and two other treatments.

Conclusions

This modified Delphi study developed a comprehensive set of recommendations that represent a useful resource for guiding decision-making on the content and delivery of pre-operative TKR education and prehabilitation. The recommendations will need to be interpreted and reviewed periodically in light of emerging evidence.

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Title: Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study
Authors: Anna M. Anderson
Christine Comer
Toby O. Smith
Benjamin T. Drew
Hemant Pandit
Deborah Antcliff
Anthony C. Redmond
Gretl A. McHugh
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Knee-TEP
Knee-TEP
Care
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04160-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Consensus on pre-operative total knee replacement education and prehabilitation recommendations: a UK-based modified Delphi study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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