Patients' experiences and satisfaction at one year following primary total knee arthroplasty: A focus‐group discussion

Abstract

Objective: To date, no study has explored patients' experiences, outcome expectations and satisfaction 1-year post-total knee arthroplasty (TKA) using focus-group discussion (FGD). The exploration of patients' expectations, functional recovery and limitations may support future modifications and thus improve outcomes post-TKA. Methods: An FGD was conducted with patients at 1-year post-TKA. Moderators led the discussion using a semistructured discussion guide. The discussion was digitally recorded, transcribed verbatim and analysed to formulate themes. Results: The study identified four main themes: recovery experience post-TKA, experience before TKA, activity of daily living (ADL) changes post-TKA and post-TKA outcome expectations. The recovery experience theme explores the overall experience post-TKA in terms of symptoms and progression issues; their experience with the orthopaedic surgeon and physiotherapy; and the differences between first and second knee replacements. The experience before TKA theme discusses many issues raised by patients that they believed strongly affected TKA outcomes and their satisfaction, such as the referral process, ADL limitations before TKA and their beliefs about post-TKA outcomes. The ADL changes post-TKA theme discusses the diversity of functional improvements, limitations and new functional ability. The outcome expectation theme explores what the patients expected to gain from surgery and the factors that modified those expectations, and whether their expectations were met. Conclusions: Patient attitude, sufficient preoperative education, outcome expectation modification, communication with the surgeon and patients taking an active role in rehabilitation can all affect post-TKA outcomes and satisfaction. Hence, the recommendation is to address all of these issues before TKA to enhance outcomes and patient satisfaction.

Content and delivery of pre-operative interventions for patients undergoing total knee replacement: a rapid review

“…and the views study. The only finding of note was that one outcomes study did not identify any significant benefits of an acupuncture plus exercise intervention [61], contrasting with the perceived value of acupuncture reported by Bin Sheeha et al [75].…”

“…In a consensus development study by Westby et al [30], a proposed quality indicator (QI) states that patients undergoing TKR should commence an individually tailored, progressive exercise program at least 8 weeks pre-operatively and lists specific exercise components that should be included. Bin Sheeha et al [75] conducted a qualitative study in which two participants reported that they valued receiving pre-operative exercise guidance from a physiotherapist. Conversely, three participants did not recommend pre-operative physiotherapy because they did not find it helpful or felt that the same exercises could be obtained online [75].…”

“…Bin Sheeha et al [75] conducted a qualitative study in which two participants reported that they valued receiving pre-operative exercise guidance from a physiotherapist. Conversely, three participants did not recommend pre-operative physiotherapy because they did not find it helpful or felt that the same exercises could be obtained online [75]. In a qualitative study by Sharif et al [84], health professionals identified that web-based written information, mobile health, and remote monitoring technologies could play a role in pre-operative exercise provision, encouragement, and/or monitoring.…”

“…The aforementioned qualitative study by Bin Sheeha et al [75] was the only views study that addressed other pre-operative TKR interventions (Table 8). Bin Sheeha et al [75] reported that two participants found acupuncture helpful before their surgery. However, it was unclear whether participants' views were about acupuncture delivered solely in the pre-operative phase.…”

Focus Group Discussion as a Tool to Assess Patient-Based Outcomes, Practical Tips for Conducting Focus Group Discussion for Medical Students—Learning With an Example

“…It can be used to explore the outcomes that cannot be explained statistically. Responses in FGD are spoken open-ended, relatively broad, and qualitative (13). They have more depth and variety.…”