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Rheumatology Advance Access published online on May 3, 2005
Rheumatology, doi:10.1093/rheumatology/keh674
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received November 4, 2004
Accepted April 1, 2005

Original Papers

Outcomes of total knee replacement: a qualitative study

G. M. Woolhead 1*, J. L. Donovan 1, and P. A. Dieppe 2

1 Department of Social Medicine, Canynge Hall, University of Bristol, UK
2 Medical Research Council Health Services Research Collaboration, Canynge Hall, University of Bristol, UK

* To whom correspondence should be addressed.
G. M. Woolhead, E-mail: Gillian.Woolhead{at}bristol.ac.uk


  Abstract

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.

Keywords: Osteoarthritis; Total knee replacement; Qualitative research; Outcomes.
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