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. 2018 Oct 2;19(1):352.
doi: 10.1186/s12891-018-2264-7.

Infection after knee replacement: a qualitative study of impact of periprosthetic knee infection

Charlotte M Mallon  1 , Rachael Gooberman-Hill  1   2 , Andrew J Moore  3
Affiliations

Infection after knee replacement: a qualitative study of impact of periprosthetic knee infection

Charlotte M Mallon et al. BMC Musculoskelet Disord. .

Abstract

Background: Approximately 340,000 knee replacements are performed each year in the USA and UK. Around 1% of patients who have had knee replacement develop deep infection around the prosthesis: periprosthetic knee infection. Treatment often requires a combination of one or more major operations and antibiotic therapy. This study aimed to understand and characterise patients' experiences of periprosthetic knee infection.

Methods: Qualitative semi-structured interviews were conducted with 16 patients (9 men, 7 women; 59-80 years, mean age 72) who experienced periprosthetic knee infection and subsequent revision treatment in six National Health Service orthopaedic departments. Interviews were audio-recorded, transcribed, anonymised and analysed thematically. The concept of biographical disruption was used to frame our analysis, and four transcripts double-coded for rigour. Patients were interviewed between two and 10 months after surgical revision.

Results: Participant experiences can be characterised according to three aspects of biographical disruption which we have used to frame our analysis: onset and the problem of recognition; emerging disability and the problem of uncertainty, and chronic illness and the mobilisation of resources. Participants' experiences of infection and treatment varied, but everyone who took part reported that infection and revision treatment had devastating effects on them. Participants described use of social and healthcare support and a need for more support. Some participants thought that the symptoms that they had first presented with had not been taken seriously enough.

Conclusions: Periprosthetic knee infection and its treatment can be life-changing for patients, and there is a need for greater support throughout treatment and lengthy recovery. Future work could look at preparedness for adverse outcomes, help-seeking in impactful situations, and information for healthcare professionals about early signs and care for periprosthetic infection.

Keywords: Biographical disruption; Impact; Periprosthetic infection; Qualitative; Revision; Surgical treatment.

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Conflict of interest statement

Ethics approval and consent to participate

This study was performed in accordance with the Declaration of Helsinki and full written informed consent to participate in the study and for quotations to be used was obtained from all participants. Ethics approval for the study was granted by NRES (National Research Ethics Service) Committee South West —Exeter (14/SW/0072) on 29th April 2014.

Consent for publication

Not applicable

Competing interests

AJM and RG-H are members of the Editorial Board of BMC Musculoskeletal Disorders.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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