Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

This study explores patients' personal meanings of knee osteoarthritis (OA) and total knee replacement (TKR). Personal meanings are important because decisions regarding the need for TKR do not seem to be explained by symptoms alone. A total of 18 semi-structured interviews were conducted with a purposive sample of respondents who were listed for TKR at one UK specialist orthopaedic hospital, and who had lower than average disease burden according to standard quantitative criteria. Data were analysed using interpretive phenomenological analysis. Several themes related to need for TKR emerged: adoption of the medical model, a person's social network, pain, functional loss, feelings of vulnerability, dependency, low mood and fatigue, ideas related to disease progression and expectations of TKR. Results suggest that the decision to undergo TKR is not related to symptoms alone, but to personal meanings. Some of these personal meanings may not be useful in accurately assessing the need for TKR, and may result in mis-targeting of treatment. It is important for health professionals to explore and tackle personal meanings when considering treatment. In particular, it may be important to consider gender differences that may influence when men and women are listed for TKR. For example: women may be less likely to discuss treatment options with their doctor; they may be more likely to have heard negative examples of TKR from friends or family; they may be more likely to discuss pain and mobility issues than activities requiring higher function; and they may be more likely to discuss the effect on their mood and the emotional impact of OA.

Original publication

DOI

10.1016/j.socscimed.2005.11.054

Type

Journal article

Journal

Social science & medicine (1982)

Publication Date

07/2006

Volume

63

Pages

43 - 53

Addresses

Department of Physiotherapy, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK. frantoye@hotmail.com

Keywords

Humans, Osteoarthritis, Knee, Disease Progression, Fatigue, Activities of Daily Living, Arthroplasty, Replacement, Knee, Adaptation, Psychological, Attitude to Health, Motivation, Decision Making, Social Support, Aged, Middle Aged, Female, Male, United Kingdom