Patients’ perspectives, pain, and health-related quality of life in same-day discharge hip and knee arthroplasty
Date
2024
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Witwatersrand, Johannesburg
Abstract
Background
International protocols for same-day discharge (SDD) following total hip (THA) and total knee arthroplasty (TKA) have recently been introduced in South Africa. Comparisons between recovery trajectories of THA and TKA patients in traditional length-of-stay models and SDD are limited. The impact of SDD related to pain, health-related quality of life and the patient perspective has yet to be studied in the South African context.
Aim
This study aimed to explore, evaluate, and compare patients' perspectives, experiences, pain, and health-related quality of life (HRQOL) following SDD after THA
and TKA.
Method
A mixed-methods design was implemented with a collection of patient-reported outcome measures (PROMs) over six weeks (n=109: 55 THA and 54 TKA) and
concluded with semi-structured interviews (n=24: 14 THA and 10 TKA). Participants scheduled for SDD THA and TKA who met the study criteria were selected through convenience sampling. Descriptive and inferential statistics were used, and a thematic analysis of interview data was conducted.
Results
There were significant improvements in PROMs by six weeks postoperatively in both groups. Significant between-group differences revealed persistent neuropathic pain (P=0.536) and worse health-related quality of life scores (p=0.102) in the TKA group. The themes identified highlight positive perspectives of SDD, emphasising unique challenges in the SDD TKA group. Findings indicate that patients undergoing SDD THA and TKA in South Africa produce results comparable to those in international studies.
Conclusion
This research advocates for a holistic approach in SDD THA and TKA, emphasising patient-centric care, effective communication, and preparation. The study contributes insights into this evolving clinical pathway and encourages further research
Description
A Dissertation submitted in fulfillment of the requirements for the degree of Masters in Physiotherapy to the Faculty of Healthcare Sciences, The University of the Witwatersrand, Johannesburg,Johannesburg 2024
Keywords
Same-day discharge, Arthroplasty, Total knee arthroplasty, Total hip arthroplasty, Pain, UCTD
Citation
Van Heerden, Martin Harry. (2024). Patients’ perspectives, pain, and health-related quality of life in same-day discharge hip and knee arthroplasty[Master’s dissertation, University of the Witwatersrand, Johannesburg]. WireDSpace.