Patients' perspectives on total knee replacement

Am J Nurs. 2008 May;108(5):54-63; quiz 63-4. doi: 10.1097/01.NAJ.0000318000.62786.fb.


Objective: Because patients' perspectives on total knee replacement (TKR) surgery have rarely been the topic of research, this study sought to describe their pre- and postoperative experiences.

Methods: Using a qualitative descriptive design, researchers collected data from a convenience sample of 27 patients who were about to undergo or had recently undergone TKR. Preoperative data were obtained in focus group sessions (n = 17); postoperative data were obtained in individual interviews (n = 10). All data-collection sessions were tape-recorded and transcribed, and transcripts were analyzed. The researchers isolated themes by identifying recurrent words and phrases and then sorted the data into thematic categories.

Results: Four main themes emerged. First, many participants delayed surgery for months to years, despite increasing pain and limitation. Second, once participants decided to proceed with surgery, they entered a period of waiting and worrying about what would happen during and after surgery. Third, both pre- and postoperative participants struggled with the need for independence, as well as with learning to accept the new knee. And fourth, patients experienced postoperative pain associated with surgery and rehabilitation, yet reported having hope that they'd regain function.

Conclusions: These findings suggest that patients need to be better educated and supported before and after TKR surgery. More research is needed to shed light on how patients' experiences influence their decisions about the surgery and its outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Anxiety / etiology
  • Arthroplasty, Replacement, Knee / psychology*
  • Female
  • Focus Groups
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Patient Satisfaction*
  • Postoperative Complications / psychology*
  • Preoperative Care / psychology*