Introduction:Kneepainisagrowinghealthproblem 12,13],TKAexperiencesofotherpeople [ 14]andcopingmechanism[ 11]inadditiontothephysician’sopinionoftheprocedure [ 15]allhaveamajorimpactonutilizationofTKA.Dependingonallthesefactorsthe patientmaynotagreeforTKAordelayitsothatsurgerybecomeslessoptimal

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Introduction:Kneepainisagrowinghealthproblem thatcausesconsiderabledisability andimpactonqualityoflifeinIndia,particularlyamongelderlypeople.Mostcommon causebeingosteoarthritis(OA),adiseasediagnosedmostlyonclinicalground 1,2 . SincethereisnodefinitivetreatmentforkneeOA,theavailabletreatmentsfocuson managingthepainanddisability .Electivesurgeryoftotalkneearthroplasty(TKA)is recommendedforpatientswithmoderatetoseverepainwhodonotrespondto symptomatictherapy 3.

ThebenefitsofTKAaredramaticandincluderestoringthe functionandthequalityoflifeforthosewithkneepain. 4,5,6,7.HoweverinIndia factorssuchassocioeconomicconditions,geography ,accesstohealthcare,patient preferences 8,knowledgeandperceptionsoftheefficacyoftheprocedure 9, 10, patientbeliefs 11,expectationsofsurgery 12,13,TKAexperiencesofotherpeople 14andcopingmechanism 11inadditiontothephysician’sopinionoftheprocedure 15allhaveamajorimpactonutilizationofTKA.Dependingonallthesefactorsthe patientmaynotagreeforTKAordelayitsothatsurgerybecomeslessoptimal .

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4, 16. Henceastudycanbedonetoassesstheknowledge,attitudeandperceptionofthe patientstowardstotalkneearthroplasty .Objective:TheperceptionsandexpectationsofthepatientstowardsTKAwouldgivean insightandhelphealthcareprofessionalstoprovideeffectiveandrelevantcareand decision making forTKA,with patients ofend-stage osteoarthritis.

Thorough understandingoftheprocedureandimplicationswillalsohelpthepatientindecision makingandsatisfaction.Methodology :Thiswillbeastudyfortwomonthsinatertiarycarehospital .Atotalof200 patientswillbetakenintoconsideration.Studywillbeconductedaccordingtoguideline ofinstituteethics.Participantswillbeinformedaboutthestudyandthosewillingto providewritteninformedconsentwillbeincludedinthisstudy .Aquestionnairewillbe providedbaseduponvariousfactorsdescribedabove.Datawillbekeptconfidential .

Implications:Thisisthefirstqualitativestudythathasattemptedtodescribethepain experiencesofpatientswithend-stageOAandtheirknowledge,attitudeandperception ofTKAinIndia.Giventheageingpopulationandlackofproperawareness,themorbidity associatedwithkneeosteoarthritisisexpectedtoincrease.Thisstudywillhelpthe practitionersaswellasthepatientsforpreoperativeconsiderationsandclinical decisionmaking.

References:1.FelsonDT,NaimarkA,AndersonJ,KazisL,CastelliW,MeenanRF:Theprevalenceof kneeosteoarthritisintheelderly .TheFraminghamOsteoarthritisStudy .ArthritisRheum. 1987,30:914-918.

2.FormanMD,MalametR,KaplanD:Asurveyofosteoarthritisofthekneeintheelderly . JRheumatol .1983,10:282-287.3.

NIH:NIH:NationalInstitutesforHealth.Totalhipreplacement .NIH Consensus Statement .1994,12: 1-314.

FortinPR,ClarkeAE,JosephL,LiangMH,TanzerM,FerlandD,PhillipsC,PartridgeAJ, BelisleP,FosselAH,etal :Outcomesoftotalhipandkneereplacement :preoperative functionalstatuspredictsoutcomesatsixmonthsaftersurgery .ArthritisRheum.1999, 42:1722-1728.5.JonesCA,VoaklanderDC,JohnstonDW,Suarez-AlmazorME:Healthrelatedqualityof lifeoutcomesaftertotalhipandkneearthroplastiesinacommunitybasedpopulation.J Rheumatol .

2000,27:1745-1752.6.MarchLM,CrossMJ,LapsleyH,BrnabicAJ,TribeKL,BachmeierCJ,CourtenayBG, BrooksPM:Outcomesafterhiporkneereplacementsurgeryforosteoarthritis.A prospectivecohortstudycomparingpatients’qualityoflifebeforeandaftersurgery withage-relatedpopulationnorms.MedJAust .

1999,171:235-238.7.HawkerG,WrightJ,CoyteP,PaulJ,DittusR,CroxfordR,KatzB,BombardierC,Heck D,FreundD:Health-relatedqualityoflifeafterkneereplacement .JBoneJointSurgAm. 1998,80:163-173.8.HawkerGA,WrightJG,CoytePC,WilliamsJI , HarveyB,GlazierR,WilkinsA,BadleyEM: Determiningtheneedforhipandkneearthroplasty :theroleofclinicalseverityand patients’preferences.MedCare.2001,39:206-216.9.Suarez-AlmazorME,SouchekJ,KellyPA,O’MalleyK,ByrneM,RichardsonM,PakC: Ethnicvariationinkneereplacement :patientpreferencesoruninformeddisparity?.Arch InternMed.2005,165:1117-1124.10.Ibrahim SA,SiminoffLA,BurantCJ,KwohCK:Variationinperceptionsoftreatment andself carepracticesinelderlywithosteoarthritis:acomparisonbetweenAfrican Americanandwhitepatients.ArthritisRheum.2001,45:340-345.11.AngDC,Ibrahim SA,BurantCJ,SiminoffLA,KwohCK:Ethnicdifferencesinthe perceptionofprayerandconsiderationofjointarthroplasty .MedCare.2002,40:471476.12.Ibrahim SA,SiminoffLA,BurantCJ,KwohCK:Differencesinexpectationsof outcome mediate African American/white patientdifferences in “willingness”to considerjointreplacement .ArthritisRheum.2002,46:2429-2435.13.MancusoCA,SculcoTP,WickiewiczTL,JonesEC,RobbinsL,WarrenRF,WilliamsRussoP:Patients’expectationsofkneesurgery .JBoneJointSurgAm.2001,83A: 1005-1012.14.McHughGA,LukerKA:Influencesonindividualswithosteoarthritisindecidingto undergoahiporkneejointreplacement :aqualitativestudy .DisabilRehabil .2009,31: 1257-1266.15.WrightJG,HawkerGA,BombardierC,CroxfordR,DittusRS,FreundDA,CoytePC: Physicianenthusiasm asanexplanationforareavariationintheutilizationofknee replacementsurgery .MedCare.1999,37:946-956.16.FortinPR,PenrodJR,ClarkeAE,St PierreY,JosephL,BelisleP,LiangMH,FerlandD, PhillipsCB,MahomedN,etal :Timingoftotaljointreplacementaffectsclinical outcomesamongpatientswithosteoarthritisofthehiporknee.ArthritisRheum.2002, 46:3327-3330

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