{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:00:11Z","timestamp":1788458411863,"version":"build-2803163510"},"reference-count":56,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["ID 422744262 -TRR 289"],"award-info":[{"award-number":["ID 422744262 -TRR 289"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,24]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Osteoarthritis (OA) commonly affects the ageing population, particularly the hip joint. Total hip arthroplasty (THA) is a frequent procedure that relieves pain and improves mobility, though some patients experience persistent postoperative pain. With rising numbers of THA, optimising perioperative care and pain management is crucial to address the growing clinical burden and improve patient outcomes. Positive treatment expectations have shown promise in enhancing outcomes, especially in pain management. This study implements two strategies to optimise the patient\u2019s treatment expectations, comprising enhanced physician communication and digital social observational learning. We will examine their separate and combined effects on preoperative expectations, negative emotions, postoperative pain, inflammation and function during recovery up to 12 months postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This randomised controlled trial (RCT) investigates the impact of augmented physician communication and observational learning on treatment expectations and recovery. Participants (n=200) will be randomised into four groups: treatment as usual (TAU), augmented doctor conversation (aDOC), observational learning video (Video) and a combination of both (aDOC+Video). The aDOC group receives empathic communication and targeted information to strengthen self-efficacy. The Video group watches a model patient demonstrating successful recovery. The combined group receives both interventions. Outcomes will be assessed at multiple time points (4\u2009days preoperatively; 1 and 4\u2009days, 4 weeks and 3, 6 and 12 months postoperatively), including subjective pain ratings, mobility and objective physical function. The primary analysis will compare changes in pain intensity across groups. Secondary outcomes will include functional status, self-efficacy, recovery and systemic inflammatory markers. Statistical analysis involves repeated measures ANOVA and post hoc tests for between-group and within-group comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>German Clinical Trials Register: DRKS00033212.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-108899","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T06:25:34Z","timestamp":1763101534000},"page":"e108899","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Optimising preoperative expectations to reduce postoperative pain and disability in total hip arthroplasty: a study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2567-5747","authenticated-orcid":false,"given":"Ana","family":"Ocokoljic","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Stuhlreyer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Paschke-Dahl","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid","family":"Elsenbruch","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Duisburg Essen, Duisburg-Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Rolvien","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank Timo","family":"Beil","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"},{"name":"Helios ENDO-Clinic Hamburg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Z\u00f6llner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regine","family":"Klinger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"2025120413274166000_15.11.e108899.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2012.02.636"},{"key":"2025120413274166000_15.11.e108899.2","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.jor.2018.03.018","article-title":"Joint perception and patient perceived satisfaction after total hip and knee arthroplasty in the American population","volume":"15","author":"Varacallo","year":"2018","journal-title":"J Orthop"},{"key":"2025120413274166000_15.11.e108899.3","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001214"},{"key":"2025120413274166000_15.11.e108899.4","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.artd.2016.09.008","article-title":"Prospective quality of life assessment after hip and knee arthroplasty: short- and mid-term follow-up results","volume":"3","author":"Martinez-Cano","year":"2017","journal-title":"Arthroplast Today"},{"key":"2025120413274166000_15.11.e108899.5","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.bja.2024.08.037","article-title":"Association between multimorbidity and quality of life after hip replacement surgery: analysis of routinely collected patient-reported outcomes","volume":"134","author":"Vickery","year":"2025","journal-title":"Br J Anaesth"},{"key":"2025120413274166000_15.11.e108899.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2011-000435","article-title":"What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? 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