Health literacy and surgery expectations in total hip and knee arthroplasty patients

Patient Educ Couns. 2018 Oct;101(10):1823-1827. doi: 10.1016/j.pec.2018.05.021. Epub 2018 May 28.


Objectives: This study assessed patients' health literacy and expectations for total hip (THA) and total knee (TKA) replacement surgery, and compared health literacy levels of patients and their caregivers.

Methods: A convenience sample of 200 THA/TKA participants, patients and their caregivers, participated in this study.

Results: Results demonstrated no statistical difference in health literacy between patients and their caregivers. However, patients with lower health literacy had significantly lower expectations for walking after surgery.

Conclusions: Practices should be aware that caregivers may not be any better equipped to consume and use complicated patient education materials than the patient they are assisting. Additionally, lower health literacy, rather than or in addition to race or social factors, may contribute to disparities in opting for THA/TKA because of lower expectations for walking after surgery.

Practice implications: Healthcare practices should develop patient educational materials that are easy for all patients and caregivers to understand, especially those with low health literacy. Additional patient education and counseling may help patients with low health literacy realistically align their expectations and mitigate barriers to consenting to surgery due to low expectations.

Keywords: Health literacy; Orthopaedics; Patient education; Patient expectations; Readability; Surgery expectations.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / psychology*
  • Arthroplasty, Replacement, Knee / psychology*
  • Caregivers / psychology*
  • Comprehension*
  • Female
  • Guidelines as Topic
  • Health Literacy*
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures
  • Patient Education as Topic*
  • Patient Satisfaction
  • Preoperative Care*
  • Recovery of Function
  • Treatment Outcome