What are the postoperative experiences of patients who have undergone hip and knee joint replacement? A literature review.

Abstract

Background: There are an increasing number of people undergoing hip and knee joint replacement each year; approximately 68,000 hip and 76,000 knee replacements, respectively, are performed in England and Wales. Joint replacements serve to reduce pain and improve function. Objectives: The purpose of this qualitative literature review is to gain an in depth understanding into participants’ postoperative experiences following hip and knee replacement in order to establish if participants can be better supported post joint replacement and whether preoperative education can be enhanced. Methods: Searches were carried out in 13 online scientific databases (January 1995 to October 2016) to identify relevant studies. The quality of studies was assessed, data were extracted and analysed using thematic synthesis. Results: A total of 197 studies were identified and screened against the inclusion/exclusion criteria. Seven studies met the inclusion criteria. Three broad themes were identified; coping with pain, recovering function and the challenges of discharge. In general, pain was poorly understood and difficulties arose with the appropriate management postoperatively. The recovery process took commitment and required individuals to have realistic expectations. Participants also felt the need for individualised care as they approached discharge. Conclusions: Overall qualitative evidence surrounding postoperative views of participants is limited. It appears current preoperative education does not fulfil the majority of participants’ needs. Utilising the views of participants may help to tailor preoperative education or provide alternative support postoperatively. Future research should focus on clarifying the effect of a well-constructed and well-delivered preoperative education sessions.