A study led by Dr. Ann F. Jacobson, associate professor in Kent State’s College of Nursing, unveils the reasons why people may initially choose to postpone but ultimately undergo total knee replacement surgery and emphasizes the need for better patient education before and after the procedure.
“This study sought to better understand patients’ pre-and post operative experiences with total knee replacement surgery,” says Jacobson. “These patients’ perspectives have rarely been the topic of research yet numerous existing studies of total joint replacement of the hip or knee indicate that eligible patients delay or decline the procedure for reasons that haven’t been well understood.”
The Four Themes of Patient Experience
Study results identified four overarching themes in patients’ experiences of total knee replacement, which the researchers named “putting up and putting off,” “waiting and worrying,” “letting go and letting in,” and “hurting and hoping.”
A participant described “putting up and putting off” as, “I’m tired of it. I am a very active person.” Another explained “putting off” the decision to have total knee replacement as, “you just keep hoping it will get better.”
The “waiting and worrying” stage begins after deciding to undergo surgery. One person said “I put this off for years. I can’t wait to get it over with.” This period involves worrying that “something can go wrong.”
The experience of “letting go and letting in” was described as “I had to accept the loss of control” and independence and “letting in” by accepting help and encouragement. One aspect of encouragement was hearing from others who had successful total knee replacement outcomes.
The “hurting and hoping” aspect of the experience was pervaded by pain: “The pain is the main thing with the knee,” but also by hope: “Gotta keep your eye on the prize.”
Patients yearned for a return to being a “normal human being,” doing such everyday things as housework, walking the dog, or gardening, with ease and comfort.
Source: Kent State University
Related stories:
How often do hip and knee replacements need revision?
A comprehensive study using nationwide data on hip and knee replacements in England has found that one in seventy-five patients require a revision of their joint replacement after three years. Although this compares favourably with the rest of the world, the study published in this week's
PLoS Medicine reinforces concerns about the new surgical techniques of hip resurfacing and unicondylar knee replacement.
New test to diagnose osteoarthritis early
A newly developed medical imaging technology may provide doctors with a long-awaited test for early diagnosis of osteoarthritis (OA), scientists from New York reported today at the 236th National Meeting of the American Chemical Society. By far the most common form of arthritis, OA is a bane of the Baby Boom generation, causing joint pain and disability for more than half of those over 65 – nearly 21 million people in the United States.
Overweight men at risk of osteoarthritis of both hip and knee
Men who are overweight or obese are much more likely need a hip replacement for osteoarthritis than men who are of normal weight, finds research published online ahead of print in
Annals of Rheumatic Diseases.
Are blood thinners post-op killers?
Current US guidelines for the prescription of potent anticoagulants by surgeons who perform joint replacement operations could be doing patients more harm than good, according to Dr. Nigel Sharrock and his team from the Hospital for Special Surgery in New York. They argue for a revision of the American College of Chest Physicians’ guidelines, in light of their review showing that the use of powerful anticoagulants to prevent pulmonary embolism may actually lead to more deaths among patients who take these drugs. The paper was published in the March issue of Springer’s journal
Clinical Orthopaedics and Related Research.
Gender bias may affect care of people with osteoarthritis, study finds
Unconscious prejudices among doctors may explain why women complaining of knee pain are less likely than men to be recommended for total knee replacement surgery, a study in today's issue of the
Canadian Medical Association Journal suggests.
FDA approves knee-injury device for humans
A new knee-surgery device investigated by University of Missouri-Columbia researchers that will help to repair meniscus tears, which were previously defined as irreparable, has been approved by the FDA for use in humans.
Genetics determine optimal drug dose of common anticoagulant
Genetic testing can be used to help personalize the therapeutic dosage of warfarin, a commonly-used anticoagulant, according to research published in the September 1, 2007, issue of
Blood, the journal of the American Society of Hematology. This result represents one of the first applications of using an individual’s genetic information to guide personal medical care.
'Shrug off' shoulder surgery myth, study suggests
Contrary to widespread belief, total surgical replacement of arthritic shoulder joints carries no greater risk of complications than replacement of other major joints, a Johns Hopkins study suggests.