Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgery
Abstract Background Knee replacement (KR) is the most common osteoarthritis (OA) related surgery. Studies suggest that there are major international and national disparities in pre-operative information, support and access to rehabilitation which have a substantial impact on patients’ perceived outc...
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| Language: | English |
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BMC
2025-06-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-05989-5 |
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| author | Anna Cronström Thérése Jönsson Gunilla Limbäck Marcus Ljung Caroline Ståhl Elin Östlind |
| author_facet | Anna Cronström Thérése Jönsson Gunilla Limbäck Marcus Ljung Caroline Ståhl Elin Östlind |
| author_sort | Anna Cronström |
| collection | DOAJ |
| description | Abstract Background Knee replacement (KR) is the most common osteoarthritis (OA) related surgery. Studies suggest that there are major international and national disparities in pre-operative information, support and access to rehabilitation which have a substantial impact on patients’ perceived outcomes of the KR. The aim of this qualitative study was to explore experiences and perceptions of the care pathway in patients who have undergone KR and subsequent rehabilitation in Sweden. Methods Four focus group discussions were performed including in total 25 patients (16 women), median age 67.5 (range) (46–81 years), 1 to 15 months after KR. The discussion recordings were transcribed verbatim and were analysed qualitatively using content analysis with an inductive approach. Results The analysis resulted in four categories: (1) The crooked road towards surgery, (2) Needing support throughout the whole journey, (3) Feelings of psychological distress and (4) A balancing act towards a new life. A lack of pre-operative information regarding expected pain, need of support and mental well-being were described. Although the journey was sometimes tough, patients’ expectations were, however, often fulfilled and they were in general satisfied with the decision to undergo surgery. Conclusions Some of the challenges identified in this study may be alleviated by sufficient pre-operative information covering realistic expectations on surgery outcomes and mental aspects as well as emphatic and holistic support by healthcare providers. The result of this study will aid in the development and implementation of a national clinical practice guideline to ensure patient-centered care throughout the KR care pathway. |
| format | Article |
| id | doaj-art-c8ffaaf0857f48418287cdb50909f708 |
| institution | OA Journals |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-c8ffaaf0857f48418287cdb50909f7082025-08-20T02:05:38ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-06-0120111110.1186/s13018-025-05989-5Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgeryAnna Cronström0Thérése Jönsson1Gunilla Limbäck2Marcus Ljung3Caroline Ståhl4Elin Östlind5Department of Health Sciences, Faculty of Medicine, Lund UniversityDepartment of Health Sciences, Faculty of Medicine, Lund UniversityInstitute of Clinical Sciences at Sahlgrenska Academy, department of Orthopaedics, University of GothenburgUnit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping UniversityDepartment of Orthopedic, Ängelholm HospitalDepartment of Health Sciences, Faculty of Medicine, Lund UniversityAbstract Background Knee replacement (KR) is the most common osteoarthritis (OA) related surgery. Studies suggest that there are major international and national disparities in pre-operative information, support and access to rehabilitation which have a substantial impact on patients’ perceived outcomes of the KR. The aim of this qualitative study was to explore experiences and perceptions of the care pathway in patients who have undergone KR and subsequent rehabilitation in Sweden. Methods Four focus group discussions were performed including in total 25 patients (16 women), median age 67.5 (range) (46–81 years), 1 to 15 months after KR. The discussion recordings were transcribed verbatim and were analysed qualitatively using content analysis with an inductive approach. Results The analysis resulted in four categories: (1) The crooked road towards surgery, (2) Needing support throughout the whole journey, (3) Feelings of psychological distress and (4) A balancing act towards a new life. A lack of pre-operative information regarding expected pain, need of support and mental well-being were described. Although the journey was sometimes tough, patients’ expectations were, however, often fulfilled and they were in general satisfied with the decision to undergo surgery. Conclusions Some of the challenges identified in this study may be alleviated by sufficient pre-operative information covering realistic expectations on surgery outcomes and mental aspects as well as emphatic and holistic support by healthcare providers. The result of this study will aid in the development and implementation of a national clinical practice guideline to ensure patient-centered care throughout the KR care pathway.https://doi.org/10.1186/s13018-025-05989-5Knee osteoarthritisKnee replacement surgeryLived experienceQualitative researchQuality of care |
| spellingShingle | Anna Cronström Thérése Jönsson Gunilla Limbäck Marcus Ljung Caroline Ståhl Elin Östlind Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgery Journal of Orthopaedic Surgery and Research Knee osteoarthritis Knee replacement surgery Lived experience Qualitative research Quality of care |
| title | Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgery |
| title_full | Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgery |
| title_fullStr | Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgery |
| title_full_unstemmed | Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgery |
| title_short | Stairway to heaven via the highway to hell: a qualitative study on patients’ experience of knee joint replacement surgery |
| title_sort | stairway to heaven via the highway to hell a qualitative study on patients experience of knee joint replacement surgery |
| topic | Knee osteoarthritis Knee replacement surgery Lived experience Qualitative research Quality of care |
| url | https://doi.org/10.1186/s13018-025-05989-5 |
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