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Stairway to heaven via the highway to hell : a qualitative study on patients’ experience of knee joint replacement surgery

Cronström, Anna LU orcid ; Jönsson, Thérése LU ; Limbäck, Gunilla ; Ljung, Marcus ; Ståhl, Caroline and Östlind, Elin LU (2025) In Journal of Orthopaedic Surgery and Research 20(1).
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... (More)

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.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Knee osteoarthritis, Knee replacement surgery, Lived experience, Qualitative research, Quality of care
in
Journal of Orthopaedic Surgery and Research
volume
20
issue
1
article number
570
publisher
BioMed Central (BMC)
external identifiers
  • scopus:105007545545
  • pmid:40474291
ISSN
1749-799X
DOI
10.1186/s13018-025-05989-5
language
English
LU publication?
yes
id
e655fd83-8844-48db-bbd3-a8f9c7d583aa
date added to LUP
2025-10-27 09:47:12
date last changed
2025-12-22 16:01:33
@article{e655fd83-8844-48db-bbd3-a8f9c7d583aa,
  abstract     = {{<p>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.</p>}},
  author       = {{Cronström, Anna and Jönsson, Thérése and Limbäck, Gunilla and Ljung, Marcus and Ståhl, Caroline and Östlind, Elin}},
  issn         = {{1749-799X}},
  keywords     = {{Knee osteoarthritis; Knee replacement surgery; Lived experience; Qualitative research; Quality of care}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Journal of Orthopaedic Surgery and Research}},
  title        = {{Stairway to heaven via the highway to hell : a qualitative study on patients’ experience of knee joint replacement surgery}},
  url          = {{http://dx.doi.org/10.1186/s13018-025-05989-5}},
  doi          = {{10.1186/s13018-025-05989-5}},
  volume       = {{20}},
  year         = {{2025}},
}