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Outcomes of total knee replacement: a qualitative study.

Woolhead GM, Donovan JL, Dieppe PA

Department of Social Medicine, Canynge Hall, University of Bristol, Bristol, BS8 2PR, UK. Gillian.Woolhead@bristol.ac.uk

OBJECTIVE: To investigate patients' experiences of outcome from a total knee replacement (TKR). METHODS: In-depth interviews were conducted with 25 patients 3 months before TKR, with 10 interviewed again 6 months after surgery. Patients were purposively sampled to include a range of demographic characteristics. Interviews were audiotaped and transcribed. Methods of constant comparison were used to analyse the data. RESULTS: Individuals struggled to make sense of their outcome and often described it in contradictory terms. When asked directly, most reported a good outcome, but further discussion revealed concern and discomfort with continuing pain and mobility difficulties. These apparently contradictory accounts were consistent with the presentation of public and private views, were dependent on the context of patients' lives, and represented an adaptation to their changed health state. CONCLUSION: Individuals reported their outcome from TKR as good despite the continued experience of pain and immobility. Although TKR has been shown to be a highly effective procedure using quantitative methods, they may need to be qualified by these qualitative findings.

Published 21 July 2005 in Rheumatology (Oxford), 44(8): 1032-7.
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