Patient Centeredness in Total Joint Replacement

Patient-centered care (PCC) is gaining considerable momentum among health care professionals and policy-making authorities. The need for PCC stems from the innumerable benefits of adopting such a system. The practice of PCC in orthopedic surgery in general, and in total joint replacement in particular, is still in its youth. However, present literature already establishes the need for applying PCC in total joint replacement. Extensive research and effort should be invested to better grasp and define the dimensions of PCC as they relate to total joint replacement.

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The benefits of PCC necessitates that the practice start sooner rather than later, and that governmental agencies, institutions, and various stakeholders invest in setting up dedicated centers to that end.

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Communication requires the combined efforts and active participation of the patient, PCP, surgeon, family, administrators, and anyone involved in the health care system ( Fig. 1 ). Even though communication should always cover the essentials of informed consent (diagnosis, prognosis, alternatives), it should also include the patient’s expectations, needs, perspectives, social values, and other aspects of care. Communication involves educating the patient and also serves as an educational process to the surgeon and the PCP to treat the patient rather than the disease. Finally, the gap in communication between PCP and orthopedic surgeons should also be filled to avoid delay in patient care. To that end, the health care system should invest in centers dedicated to PCC. These centers should tie together the different variables in this complex equation. It should also oversee and guide the communication needed, by the different technologies at hand, in a coherent integrated flow that is evidence-based and patient-centered.

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