Here is your chance to help with a bit of research. This survey will help us to
learn which surgical procedures we AVN patients undergo, what our results
are, and how we feel about our results.
Please remember that if you wish to change any answers, you can either
change them one by one, or you can hit the Reset button at the bottom and
redo the entire page. Your survey will be emailed directly to our office and
none of this data will remain on the Web.  Please fill out this form for one
surgical procedure at a time only. If you have had more than one surgery, then
please fill out additional survey form(s). Thank you for taking the time to help
us to help all of you.
Required fields marked with an asterisk *
Name *
Subject:
Email address *
Age *
Registered member *
 Yes
 No
What surgical procedure did you have?
Choose only one per survey entry
If you checked "other", what surgery was it?
Year of your surgery:
At what stage was your AVN at the time of your
surgery?
Was the affected joint showing any
signs or degree of collapse? If
Yes, please choose amount.
In what way(s) did your surgeon or
hospital prepare you for surgery?  
(Hold down CTRL key to choose
more than one)
Did you have a consultation with
an anesthesiologist prior to your
surgery?
How long was your hospital stay?
Do you feel you had sufficient pain control
post-op? Choose all that apply. (Hold down CTRL
key to choose more than one)
For how long were you non-weight
bearing, if applicable?
How much prescribed physical therapy
did you have, if any?
How soon after your surgery did
you start doctor- prescribed
physical therapy?
How long until you could resume
your normal or usual daytime
activities, such as return to work,
etc?
Were you sent to a rehab or similar
care  center after your discharge
from hospital?
Did you require help once you first
returned home,and if so about how
much?
Did your doctor or hospital provide
you with any tools/help aids when
you went back home? (grabber tool,
reacher, walker, crutches, etc.)
Before you went into the hospital,
did you prepare your home for
your return and if so, how? (hold
CTRL key down for multiple choices)
What else do you think you should
have done, or would do next time,
before surgery?
Do you feel you got the results you
expected or hoped for from this
surgery? (hold down CTRL key to choose more
than one)
How would you rate your over-all
experience (1 to 10 with 1 being
the worst, 10 the best), and
BRIEFLY tell why (20 words or so)
One last really important question!
What was your response time if you had to call
your doctor for any problems, concerns or
questions after your return home?
Thanks so much for taking the time to participate in our survey. The
more information we gather and can submit to those involved in
research, the better for all AVN sufferers, both present and all those
yet to come.
Please note: All survey submissions become the property of the ON/AVN
Support Group Int'l Association, Inc., and we reserve the right to use this
information as we see fit for research purposes.
Copyright 2005 - The ON/AVN Support Group Int'l Association, Inc.
    To information on how to
    make a donation, please see
    our  Donations page.....
      
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Surgical Procedures Survey - 2005

The ON/AVN Support Group Int'l Association, Inc.