Abstract
Purpose: The aim of this survey was to assess the practice of obtaining informed consent for Total Knee Replacement Surgery in the United Kingdom.
Method: A postal questionnaire was distributed to consultant members of the British Orthopaedic Association. They were questioned regarding their practice for obtaining informed consent for Total Knee Replacement Surgery.
Results: Of the 1571 consultant members contacted 34% (526) replied. From these 76% (400) performed total knee replacements. Informed consent was obtained in a pre-operative assessment clinic in 64%, on admission in 32.5% and during the first clinic visit in 3.5% of cases. Consent was routinely obtained by Consultants in 76%, Senior House Officers in 38%, Pre-Registration House Officers in 4% and Specialist Nurses in 5% of cases. Consultants warned of the following complications: Infection 99.2%, Stiffness 70.5%, Aseptic loosening 81.6%, neurovascular damage 56.9%, DVT 96.5%, PE 88.5%, Wear 61.2% and Mortality 67.4%. Patient information leaflets were provided by 71.5% of consultants for Total Knee Replacement.
Conclusions: This survey has identified inconsistencies in the complications described to patients. Junior practitioners are continuing to obtain informed consent. Informed consent should be obtained by a suitably experienced practitioner. Patient information leaflets should be provided to patients at the time of listing. We recommend national guidelines relating to obtaining consent for Total Knee Replacement should be published by the BASK. These could be incorporated into their best practice document regarding Total Knee Replacement Surgery.
Honorary Secretary – Mr Roger Smith. Correspondence should be addressed to BASK at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
