In shared decision making, both patients and physicians make contributions to the dialogue about a patient’s condition, the best way to achieve the optimal outcome and treatment options following a total knee or hip replacement. The surgeon contributes expert clinical knowledge about the condition, the natural history of the condition, the treatment options available with associated risks, and benefits and the limitations of currently available evidence.
The patient discusses their goals and expectations, what their personal preferences are with regard to their treatment options and what they value. There are a variety of ways that this dialogue can be fostered, and these include patient handouts, web-based information and other means of information dissemination. The more informed the patient is regarding their condition and treatment options, the more likely they will be able to make a rational decision about proceeding with a specific treatment.
We encourage patients to bring questions regarding their condition and treatment options and to think about what it is they hope to achieve after a particular treatment. The ability to align the results of joint replacement surgery with the expectations of the patient has a greater likelihood of leading to a happier patient after surgery.
Once a decision is reached about how to proceed with a surgical intervention, it is up to the patient, along with the assistance of the physician, to optimize his or her health so as to minimize the associated risks. There is no treatment that is risk-free, but optimizing one’s health and physical conditioning prior to having surgery, including attention to weight, treatment of various medical conditions, smoking cessation, and improvement in strength, will help decrease the risk of a complication following the operation.
Dr. Barrett is an orthopedic surgeon who performs over 500 joint replacement surgeries annually. For more information about total hip and knee replacements, contact Proliance Orthopedic Associates at 425.656.5060.