What are the postoperative experiences of patients who have undergone hip and knee joint replacement? A literature review

Abstract

Background There are an increasing number of people undergoing hip and knee joint replacement each year; approximately 68,000 hip and 76,000 knee replacements respectively are performed in England and Wales. Joint replacements serve to reduce pain and improve function. Objective The purpose of this qualitative literature review is to gain an in depth understanding into participants' postoperative experiences following hip and knee replacement in order to establish if participants can be better supported post joint replacement and whether preoperative education can be enhanced. Method Searches were carried out in 13 online scientific databases (January 1995 to October 2016) to identify relevant studies. The quality of studies was assessed, data were extracted and analysed using thematic synthesis. Results A total of 197 studies were identified and screened against the inclusion/exclusion criteria. Seven studies met the inclusion criteria. Three broad themes were identified; coping with pain, recovering function and the challenges of discharge. In general pain was poorly understood and difficulties arose with the appropriate management postoperatively. The recovery process took commitment and required individuals to have realistic expectations. Participants also felt the need for individualised care as they approached discharge. Conclusion Overall qualitative evidence surrounding postoperative views of participants is limited. It appears current preoperative education does not fulfil the majority of participants' needs. Utilising the views of participants may help to tailor preoperative education or provide alternative support postoperatively. Future research should focus on clarifying the effect of a well constructed and well-delivered pre-operative education sessions.

Challenges in rehabilitation and continuum of care provision after knee replacement: a mixed-methods study from a low- and middle-income country

“…Are you able to do? Pain preventing to exercise and do ROM related exercise [4] Poor pain management as barrier [5,6] Pain in other parts of the body [7] Limited ROM [7] Loss of independence [8,9] PT: Inadequately prepared to manage pain, sleep, psychological issues [6] Psychological…”

Why Do People Undergo THR and What Do They Expect to Gain—A Comparison of the Views of Patients and Health Care Professionals

“…Overall, there is a lack of evidence surrounding an individuals’ pre and post-THR views and perspectives ( 36 ). No concerted effort has been made to advocate partnership with individuals undergoing THR to understand their reasons for undertaking surgery and their ultimate rehabilitation goals.…”