BMJ Open (May 2024)

What recovery domains are important following a total knee replacement? A qualitative, interview-based study

  • Martin Underwood,
  • Paul Mitchell,
  • Andrew Metcalfe,
  • Chetan Khatri,
  • David Ellard,
  • Fatema Dhaif,
  • Jeremy Neil Rodrigues

DOI
https://doi.org/10.1136/bmjopen-2023-080795
Journal volume & issue
Vol. 14, no. 5

Abstract

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Objectives To explore people’s views of recovery from total knee replacement (TKR) and which recovery domains they felt were important.Design Semi-structured interviews exploring the views of individuals about to undergo or who have undergone TKR. A constant-comparative approach with thematic analysis was used to identify themes. The process of sampling, collecting data and analysis were continuous and iterative throughout the study, with interviews ceasing once thematic saturation was achieved.Setting Tertiary care centre.Participants A purposive sample was used to account for variables including pre, early or late postoperative status.Results 12 participants were interviewed, 4 who were preoperative, 4 early postoperative and 4 late postoperative. Themes of pain, function, fear of complications, awareness of the artificial knee joint and return to work were identified. Subthemes of balancing acute and chronic pain were identified.Conclusions The results of this interview-based study identify pain and function, in particular mobility, that were universally important to those undergoing TKR. Surgeons should consider exploring these domains when taking informed consent to enhance shared decision-making. Researchers should consider these recovery domains when designing interventional studies.