Shared decision-making is a process whereby physicians and patients exchange information and arrive at an agreement about the patient’s preferred treatment option. This is predicated on the concept that there is one best solution for a particular patient’s problem. Other theories suggest that patients can make decisions both analytically and intuitively through a parallel decision-making process depending on how the choice is framed. Based on this theory, patients can make a decision with an intuitive process, but then after surgery, use a more analytic process to evaluate their results. This can lead to a patient having a set of expectations prior to surgery not based on a complete review of all the facts, or perhaps a review of the facts as they were represented, and even though a good surgical procedure is performed and what seems to be a good outcome obtained, the patient may not be completely satisfied with the outcome. To help alleviate these conflicting results, it seems best to have a fairly standardized presentation of common procedures and expectations to eliminate bias on the part of the surgeon and patient.
This has relevance to patients considering total hip and knee replacement. The pain relief of both hip and knee replacement has been well established. Patient satisfaction varies depending on the severity of the arthritis, the health and fitness of the patient, the volume of procedures performed by the surgeon and the hospital. For patients considering hip and knee replacement it is important that they have a series of questions that they review with the surgeon prior to considering surgery to make sure they understand the indications, the options, and the outcomes from a proposed surgical treatment. It is also legitimate to query the surgeon about the number of cases they have performed and their outcomes with regard to patient satisfaction, and complications. Ultimately, the decision to undergo surgery is the patient’s after review of their various options and discussions with one or more surgeons.