An exploration into young patients’ (≤ 50 years) expectations following primary total hip arthroplasty; An Interpretative Phenomenological Analysis study.

Abstract

Title: YOUNG HIP: An exploration into young patients’ (<50 years) expectations following primary total hip arthroplasty: An Interpretative Phenomenological Analysis study. Introduction. Total hip replacements (THR) are common operations performed in orthopaedics. Though initially developed to address hip conditions in older patients, demand in younger patients is increasing. Research in older populations informs current practice and it is unclear if outcome priorities important to older patients are similar in younger patients, or if younger THR patients consider other outcomes more important. Patient-reported outcome measures (PROMs), routinely used in clinical practice, aim to evaluate the success of interventions from the patient’s perspective. However, these standard questionnaires may not account for differences in priorities across various demographic groups. Aims Young Hip’s primary aim was to explore younger patients’ (<50 years) expectations and priorities when undergoing primary elective THR. Methods Four studies were undertaken: a systematic literature review (study 1), a Public and Patient Involvement (PPI) study (study 2), a bibliographic review (study 3), and a qualitative study (study 4). Study 1 highlighted the current absence of qualitative research on THR patients, the aim of study 2 was to reveal themes from the patient perspective not currently addressed by existing healthcare pathways, and study 3 underlined the minimal use of qualitative methodologies in research published in orthopaedic journals. These studies underscored the necessity and rationale for further exploration into the priorities of younger THR patients through qualitative enquiry. Therefore, study 4 utilised Interpretative Phenomenological Analysis (IPA) to examine the experiences of ten patients from a UK hospital. Semi- structured interviews were conducted at three timepoints: pre-surgery, six-weeks post- surgery, and six-months post-surgery. Data was analysed individually before cross-case analysis explored the similarities and differences between participants. Additionally, participants completed validated PROMs questionnaires at each timepoint, these results were compared with the qualitative data to assess whether PROMs accurately reflected the participants’ experiences and concerns. Findings These findings suggest that younger patients face distinct psychological and social challenges that are often overlooked in standard care pathways.