Patient and healthcare professional perspectives on which potential prognostic factors for failure of total elbow replacement should be investigated

Abstract

Background: Total elbow replacement (TER) is an established treatment for the painful arthritic elbow; however, TER has higher failure rates than other joint replacements, such as hip and knee replacement. Understanding the prognostic factors associated with failure of TER is essential for informed decision-making between patients and clinicians, patient selection, and service planning. The aim of this study is to explore the views of patients and healthcare professionals on which potential prognostic factors should be investigated in relation to TER failure. Methods: This evaluation comprised of two Patient and Public Involvement (PPI) workshops and a survey. PPI workshop 1 consisted of five PPI participants who helped to develop a survey assessing the importance of potential prognostic factors to investigate. The survey was shared electronically with members of the British Elbow and Shoulder Society (BESS) and clinicians internationally. In PPI workshop 2, 15 PPI participants listed factors they thought important to investigate, and 12 completed the survey. Results: Patients and healthcare professionals agreed that most factors in the survey should be investigated. Although this is not a comparative study, more of the healthcare professionals disagreed that ethnicity (49% v 33%) and VTE prophylaxis (42% v none) were important enough to be investigated, whilst more of the patients disagreed that socioeconomic status is important to be investigated (54% v 17%). Patients and healthcare professionals also suggested other factors not listed in the survey. Conclusions: Patients and healthcare professionals agreed on the importance of investigating most prognostic factors, but some factors were favoured by only one group. The results of this evaluation could help researchers decide which prognostic factors to investigate and which to routinely collect.