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Research Examines Factors in Delaying or Declining Total Knee Replacement Surgery
May 15, 2008A 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.
Patients need more education and support about total knee replacement and making the decision to have it, and there is still a need for investigation into new and better ways to provide these, Jacobson says.
"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.
Kent State
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.
Kent State
Knee Replacement Current Events and Knee Replacement News RSSMarket based reforms have not harmed equity in the NHS, say researchers
Recent NHS reforms, such as the introduction of patient choice and provider competition, have not had a deleterious impact on equity with respect to waiting times for elective surgery in England.
Joint replacement patients with diabetes greatly benefit from controlled glucose
Diabetics undergoing total joint replacement often are at a higher risk of experiencing complications after surgery due to various pre-existing health conditions.
Total knee replacements increase mobility and motor skills in older patients
According to a new study from researchers at Duke University, total knee arthroplasty (TKA) procedures performed in older patients with osteoarthritis of the knee result in long-term, significant improvement of physical functioning and motor skills when compared to patients who do not receive TKA.
Severe obesity increases risks of health problems during surgery
Healthcare providers must carefully consider the unique risk factors related to severe obesity in patients undergoing all types of surgery, according to an American Heart Association scientific advisory published in Circulation: Journal of the American Heart Association.
Exercise after knee replacement critical
It may be uncomfortable at first, but doing exercises to strengthen your quadriceps after you've had knee replacement surgery due to osteoarthritis is critical to your recovery. In fact, it can boost the function of your new knee to nearly that of a healthy adult your age.
Research highlights new approaches to prevent blood clots
Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured.
Nearly half of U.S. adults will develop painful knee osteoarthritis by age 85: study
Almost half of all U.S. adults and nearly two-thirds of obese adults will develop painful osteoarthritis of the knee by age 85, a study based at the University of North Carolina at Chapel Hill suggests.
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.
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.
No justification for denying obese patients knee replacements
There is no justification for denying obese patients knee replacement surgery: They benefit almost as much as anyone else from the procedure, concludes a small study published ahead of print in the Annals of the Rheumatic Diseases.
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