A new study by researchers at the Saint Louis University has found that a patient's emotional state plays a significant role in his or her recovery from hip surgery.
After hip surgery, two tests are typically used to determine if a patient has recovered: one is a clinical measure of hip function given by the doctor, and the second is a questionnaire patients answer that considers a wide variety of factors in determining the overall success of the surgical procedure.
A team of researchers led by Berton Moed, M.D., chair of the department of orthopaedic surgery at Saint Louis University School of Medicine found that a patient's emotional status was the second-most important factor in determining how well he or she thought recovery was going.
46 patients who had been followed for at least two years after elementary posterior wall fracture surgery took part in the research.
The team noted that though the clinical measures showed that patients were recovering well, the questionnaire showed that the patients had a very different opinion.
Dr Moed says that the study shows the need to acknowledge their emotional state as a measure of recovery.
"Patients come in for check-ups after their hip surgery and the doctor says, 'Looks like you're doing fabulously,' and they respond, 'No, I'm not. I ache. They're not doing well, but why? It appears to have a lot to do with their emotional state. It's the elephant in the exam room - that is, something doctors need to acknowledge is a real issue," he said.
And one way of dealing with this issue, Dr Moed says, may be to recommend that the patients see a psychologist.
"That could include bringing in social workers and psychologists to work with the patients in the areas that surgeons, who often are super subspecialists, may not be able to deal with," he said.
Moed says both underlying depression and new depression brought on by the injury and/or surgery could be to blame for slowing a patient's recovery.
"When an active person is suddenly confined to the bed or to limited activity, it can take a toll. Not being able to do the things one used - and feeling powerless over it - may play a larger role than we thought in how well the patient feels they're recovering," he adds.
While some patients may be taken aback by the suggestion that they see a psychologist after surgery, Dr Moed thinks developing better and more customized treatment plans has the potential to help patients recover more fully - and not just after hip surgery.
"The number one issue is recognition - we need to acknowledge that there's more going on with patients than what current clinical tests tell us," he says.
The research is published in the June issue of the Journal of Bone and Joint Surgery.