Patient Adherence Following Knee Surgery: Evidence-Based Practices to Equip Patients for Success.

Patient adherence with postoperative wound care, activity restrictions, rehabilitation, medication, and follow-up protocols is paramount to achieving optimal outcomes following knee surgery. However, the ability to adhere to prescribed postoperative protocols is dependent on multiple factors both in and out of the patient's control. The goals of this review article are 1) to outline key factors contributing to patient non-adherence with treatment protocols following knee surgery, and 2) synthesize current management strategies and tools for optimizing patient adherence in order to facilitate efficient and effective implementation by orthopaedic healthcare teams. Patient adherence is commonly impacted by both modifiable and non-modifiable factors, including health literacy, social determinants of health, patient fear/stigma associated with non-adherence, surgical indication (elective vs. traumatic), and distrust of physicians or the healthcare system. In addition, healthcare team factors, such as poor communication strategies or failure to follow internal protocols, and health system factors, such as prior authorization delays, staffing shortages, or complex record management systems, impact patient's ability to be adherent. Because the majority of factors found to impact patient adherence are non-modifiable, it is paramount that healthcare teams adjust to better equip patients for success. For healthcare teams to successfully optimize patient adherence, focus should be paid to education strategies, individualized protocols that consider patient enablers and barriers to adherence, and consistent communication methodologies for both team and patient-facing communication.