Patient information ahead of anterior cruciate ligament reconstruction: Experience in a university hospital center

Introduction: Patient information is the requisite first step in securing informed consent ahead of surgery, and is legally mandatory. The study hypothesis was that this information is deficient in a significant proportion of cases. This was tested on a clinical audit. The principal objective was to quantify the rate of correct patient information communication. The secondary objectives were to assess the quality of the information provided by the physician as compared to other sources, and to assess the resultant patient satisfaction. Materials and methods: A targeted clinical audit included all patients undergoing isolated anterior cruciate ligament (ACL) reconstruction in 2009 and 2010. The information provided was analyzed from emergency admission through to the specialized orthopedic consultation, where all information should in principle be traceable in the patient's file. Concordance with information gleaned by the patient himself/herself was also assessed. Results: Seventy of the 93 patients recruited responded to the study questionnaire (75%). Forty-two had received primary care in the Emergency Department, where 67% had been informed about the ACL tear. Surgery-related information could be traced in 61% of cases; surgery had been discussed in the Emergency Department itself in half of the cases, but only 16% had been informed of the duration of the interruption of sports activity and 21% of the duration of time off work and the need for early rehabilitation. Following the orthopedic consultation, 100% of patients knew that they had an ACL tear, but surgery had been spelled out in detail for only 80%, complications for 70%, foreseeable outcome for 30%, rehabilitation for 20% and time off work for 60%. Thirty-eight patients had retrieved information from the Internet; concordance with hospital information was rated at 5.6/10 for the Emergency Department and 7.5/10 for the orthopedic consultation. Discussion: The quality of patient information remains deficient. Traceability of information in the patient's file was only 61%. In the Emergency Department, information comprised diagnosis and referral to specialist consultation. In the orthopedic consultation, information focused on surgical procedure more than on postoperative course. Family doctors and physical therapists also have a role to play, but other sources, such as validated brochures including recommended web-sites, could improve patient information. Level of evidence: IV, retrospective study. (C) 2012 Elsevier Masson SAS. All rights reserved.