{"id":{"repo_id":"uwo","oai_identifier":"oai:uwo.scholaris.ca:20.500.14721/34335"},"canonical_url":"https://search.dev.ndltd.org/etd/uwo/oai:uwo.scholaris.ca:20.500.14721/34335","repository":{"repo_id":"uwo","name":"Western University","base_url":"https://uwo.scholaris.ca/server/oai/request"},"display":{"title":"A Randomized Controlled Trial to Establish Realistic Patient Expectations Following Total Knee Replacement Surgery","abstract":"Objectives: To evaluate whether e-learning videos can affect whether patients felt their expectations were met and were satisfied with surgery 1 year following primary total knee replacement (TKR) (Chapter 3). In Chapter 4, we described characteristics of users and utilization patterns of the e-learning tool. In Chapter 5, we evaluated the internal consistency and construct validity of the new Knee Society Knee Scoring System (KSS) in a sample of TKR patients. Methods: We recruited consecutive patients with osteoarthritis from the London Health Sciences Centre, Ontario, Canada (Chapter 3). We randomized patients with osteoarthritis to either control (n=207) they received our standard patient education, or intervention (n=209) they had access to the e-learning tool in addition to our standard patient education (Chapter 4). In Chapter 5 we pooled the RCT data to evaluate the measurement properties of the new KSS. We calculated the associations between KSS and Knee Injury and Osteoarthritis Outcome Score subscales to evaluate cross-sectional and longitudinal validity and divided patients into tertiles according to their Physical Component Score on the SF-12 and compared those scores to the scores on the KSS to determine known-groups validity. We also divided patients by their rating of pre- and post-operative expectations and compared their responses to those on the pre- and post-operative expectations scores of the KSS. Results: There was no statistically significant difference between groups for expectations, RD=1.3% (95% CI -7.8% to 10.4%, p=0.78) or satisfaction, RD=0.6% (95% CI -8.4% to 9.6%, p=0.78) (Chapter 3). In Chapter 4 we found baseline characteristics of e-learning users were no different than nonusers and use of the tool was highest pre-operatively. Finally, surgeon videos that included content about expectations of surgery were most frequently viewed videos, pre- and post-operatively. In Chapter 5 we demonstrated the internal reliability, cross-sectional, longitudinal and known-groups validity of the KSS. Conclusions: In Chapter 3, we failed to demonstrate the effectiveness of an e-learning tool and showed, in Chapter 4, a reduction in use of the tool over time. In Chapter 5 we provided evidence of the measurement properties of the new KSS, which was used throughout this thesis.","abstract_html":"Objectives: To evaluate whether e-learning videos can affect whether patients felt their expectations were met and were satisfied with surgery 1 year following primary total knee replacement (TKR) (Chapter 3). In Chapter 4, we described characteristics of users and utilization patterns of the e-learning tool. In Chapter 5, we evaluated the internal consistency and construct validity of the new Knee Society Knee Scoring System (KSS) in a sample of TKR patients. Methods: We recruited consecutive patients with osteoarthritis from the London Health Sciences Centre, Ontario, Canada (Chapter 3). We randomized patients with osteoarthritis to either control (n=207) they received our standard patient education, or intervention (n=209) they had access to the e-learning tool in addition to our standard patient education (Chapter 4). In Chapter 5 we pooled the RCT data to evaluate the measurement properties of the new KSS. We calculated the associations between KSS and Knee Injury and Osteoarthritis Outcome Score subscales to evaluate cross-sectional and longitudinal validity and divided patients into tertiles according to their Physical Component Score on the SF-12 and compared those scores to the scores on the KSS to determine known-groups validity. We also divided patients by their rating of pre- and post-operative expectations and compared their responses to those on the pre- and post-operative expectations scores of the KSS. Results: There was no statistically significant difference between groups for expectations, RD=1.3% (95% CI -7.8% to 10.4%, p=0.78) or satisfaction, RD=0.6% (95% CI -8.4% to 9.6%, p=0.78) (Chapter 3). In Chapter 4 we found baseline characteristics of e-learning users were no different than nonusers and use of the tool was highest pre-operatively. Finally, surgeon videos that included content about expectations of surgery were most frequently viewed videos, pre- and post-operatively. In Chapter 5 we demonstrated the internal reliability, cross-sectional, longitudinal and known-groups validity of the KSS. Conclusions: In Chapter 3, we failed to demonstrate the effectiveness of an e-learning tool and showed, in Chapter 4, a reduction in use of the tool over time. In Chapter 5 we provided evidence of the measurement properties of the new KSS, which was used throughout this thesis.","abstract_has_math":false,"creators":["Culliton, Sharon E."],"institution":"The University of Western Ontario","degree_name":"Ph D","degree_level":null,"degree_discipline":"Health and Rehabilitation Sciences","degree_department":null,"school":null,"contributors":[],"advisors":["Bert Chesworth"],"committee_chairs":[],"committee_members":[],"year":2016,"date_issued":"2016-08-22","date_published":"2016-08-22","updated_at":"2026-07-27T21:56:11Z","subjects":["total knee replacement","expectations","satisfaction","patient education","e-learning"],"languages":["en_ca"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/20.500.14721/34335","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Bert Chesworth"]},{"key":"dc:creator","label":"Author","values":["Culliton, Sharon E."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-07-10T20:02:19Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-07-10T20:02:19Z"]},{"key":"dc:date.issued","label":"Date","values":["2016-08-22"]},{"key":"dc:publisher","label":"Institution","values":["The University of Western Ontario"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Health and Rehabilitation Sciences"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Ph D"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["total knee replacement","expectations","satisfaction","patient education","e-learning"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en_ca"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/20.500.14721/34335"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The thesis cover page in the PDF document includes references to Western University’s previous institutional repository platform, known as Scholarship@Western, and links to that platform (beginning with ir.lib.uwo.ca). In citing or referring to this thesis, use the DOI or handle from this page instead. Sample citation: Author name, \"Thesis title.\" (Year). Western University Open Repository. https://doi.org/10.71858/123456."]},{"key":"dc:description.abstract","label":"Abstract","values":["Objectives: To evaluate whether e-learning videos can affect whether patients felt their expectations were met and were satisfied with surgery 1 year following primary total knee replacement (TKR) (Chapter 3). In Chapter 4, we described characteristics of users and utilization patterns of the e-learning tool. In Chapter 5, we evaluated the internal consistency and construct validity of the new Knee Society Knee Scoring System (KSS) in a sample of TKR patients. Methods: We recruited consecutive patients with osteoarthritis from the London Health Sciences Centre, Ontario, Canada (Chapter 3). We randomized patients with osteoarthritis to either control (n=207) they received our standard patient education, or intervention (n=209) they had access to the e-learning tool in addition to our standard patient education (Chapter 4). In Chapter 5 we pooled the RCT data to evaluate the measurement properties of the new KSS. We calculated the associations between KSS and Knee Injury and Osteoarthritis Outcome Score subscales to evaluate cross-sectional and longitudinal validity and divided patients into tertiles according to their Physical Component Score on the SF-12 and compared those scores to the scores on the KSS to determine known-groups validity. We also divided patients by their rating of pre- and post-operative expectations and compared their responses to those on the pre- and post-operative expectations scores of the KSS. Results: There was no statistically significant difference between groups for expectations, RD=1.3% (95% CI -7.8% to 10.4%, p=0.78) or satisfaction, RD=0.6% (95% CI -8.4% to 9.6%, p=0.78) (Chapter 3). In Chapter 4 we found baseline characteristics of e-learning users were no different than nonusers and use of the tool was highest pre-operatively. Finally, surgeon videos that included content about expectations of surgery were most frequently viewed videos, pre- and post-operatively. In Chapter 5 we demonstrated the internal reliability, cross-sectional, longitudinal and known-groups validity of the KSS. Conclusions: In Chapter 3, we failed to demonstrate the effectiveness of an e-learning tool and showed, in Chapter 4, a reduction in use of the tool over time. In Chapter 5 we provided evidence of the measurement properties of the new KSS, which was used throughout this thesis."]},{"key":"dc:title","label":"Title","values":["A Randomized Controlled Trial to Establish Realistic Patient Expectations Following Total Knee Replacement Surgery"]}]}],"canonical_facts":{"dc:contributor.advisor":["Bert Chesworth"],"dc:creator":["Culliton, Sharon E."],"dc:date.accessioned":["2025-07-10T20:02:19Z"],"dc:date.available":["2025-07-10T20:02:19Z"],"dc:date.issued":["2016-08-22"],"dc:description":["The thesis cover page in the PDF document includes references to Western University’s previous institutional repository platform, known as Scholarship@Western, and links to that platform (beginning with ir.lib.uwo.ca). In citing or referring to this thesis, use the DOI or handle from this page instead. Sample citation: Author name, \"Thesis title.\" (Year). Western University Open Repository. https://doi.org/10.71858/123456."],"dc:description.abstract":["Objectives: To evaluate whether e-learning videos can affect whether patients felt their expectations were met and were satisfied with surgery 1 year following primary total knee replacement (TKR) (Chapter 3). In Chapter 4, we described characteristics of users and utilization patterns of the e-learning tool. In Chapter 5, we evaluated the internal consistency and construct validity of the new Knee Society Knee Scoring System (KSS) in a sample of TKR patients. Methods: We recruited consecutive patients with osteoarthritis from the London Health Sciences Centre, Ontario, Canada (Chapter 3). We randomized patients with osteoarthritis to either control (n=207) they received our standard patient education, or intervention (n=209) they had access to the e-learning tool in addition to our standard patient education (Chapter 4). In Chapter 5 we pooled the RCT data to evaluate the measurement properties of the new KSS. We calculated the associations between KSS and Knee Injury and Osteoarthritis Outcome Score subscales to evaluate cross-sectional and longitudinal validity and divided patients into tertiles according to their Physical Component Score on the SF-12 and compared those scores to the scores on the KSS to determine known-groups validity. We also divided patients by their rating of pre- and post-operative expectations and compared their responses to those on the pre- and post-operative expectations scores of the KSS. Results: There was no statistically significant difference between groups for expectations, RD=1.3% (95% CI -7.8% to 10.4%, p=0.78) or satisfaction, RD=0.6% (95% CI -8.4% to 9.6%, p=0.78) (Chapter 3). In Chapter 4 we found baseline characteristics of e-learning users were no different than nonusers and use of the tool was highest pre-operatively. Finally, surgeon videos that included content about expectations of surgery were most frequently viewed videos, pre- and post-operatively. In Chapter 5 we demonstrated the internal reliability, cross-sectional, longitudinal and known-groups validity of the KSS. Conclusions: In Chapter 3, we failed to demonstrate the effectiveness of an e-learning tool and showed, in Chapter 4, a reduction in use of the tool over time. In Chapter 5 we provided evidence of the measurement properties of the new KSS, which was used throughout this thesis."],"dc:identifier.uri":["https://hdl.handle.net/20.500.14721/34335"],"dc:language.iso":["en_ca"],"dc:publisher":["The University of Western Ontario"],"dc:subject":["total knee replacement","expectations","satisfaction","patient education","e-learning"],"dc:title":["A Randomized Controlled Trial to Establish Realistic Patient Expectations Following Total Knee Replacement Surgery"],"dc:type":["thesis"],"thesis:degree_discipline":["Health and Rehabilitation Sciences"],"thesis:degree_name":["Ph D"]},"updated_at":"2026-07-27T21:56:11Z"}