The emotional state of the patient after total hip and knee arthroplasty.

The new processes of total hip and knee arthroplasty partly engendered by mini-incision surgery have helped patients achieve all three goals of their operation: pain relief, improvement in function, and satisfaction. Satisfaction means the patient is no longer self-conscious about their disability and has regained the ability to live in their world in their usual way. The emotional state of the patient preoperatively, in the hospital, and during recovery will affect their feeling of satisfaction. Proper preoperative education makes patients more optimistic, and they anticipate fewer problems. In the hospital, a multimodal pain management program limits the use of parenteral narcotics and avoids the side effects of nausea and vomiting, which is the most important factor for in-hospital satisfaction. Recovery with an active physical therapy program individualized for the abilities and goals of the patient improves function and satisfaction. Surgeons must understand the expectations of the patient, direct them to realistic goals, and use the new processes of patient care to allow patients to exceed their expectations. (C) 2007 Lippincott Williams & Wilkins, Inc.