[Informed consent in orthopedic surgery]

Abstract

Twenty-eight patients who had total joint replacement (TJR) and twenty-eight patients who sustained open reduction for fracture within or close to the joint were studied to determine their recall of the informed consent procedure. The questionnaire covered a postoperative time range of more than 5 months and less than 6 years (average: 2 years and 4 months). The patient's recall and the doctor's document of informed consent were scored 4 points for diagnosis and treatment, 1 point for prognosis, 3 points for benefits, 4 points for complications and 1 point for alternatives with a total of 13 points. In TJR, the average recall and document score were 8.6 points and 6.5 points respectively; and in fracture, 6.6 points and 4.9 points. Fifty-seven per cent of the patients with TJR recalled the risk of infection; and 54 per cent recalled the problem of loosening. Twenty-nine per cent of the patients with fracture recalled the risk of infection, and 29 per cent the risk of nonunion. In TJR, the recall score was related to the patient's age and the document score. There was significant difference in document scores among doctors. As a result of this study, standard documents for informed consent in each operation have been compiled with the aid of a word-processor to improve the quality of informed consent.