Misconceived expectations: Patient reflections on the total knee replacement journey
Introduction: Fifty per cent of patients consent for total knee replacement (TKR) with unrealistic expectations about what it involves and can achieve. A framework is needed to help surgeons identify key knowledge gaps and misconceptions that can be targeted during the informed consent process. I...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
| Published: |
Wiley-Blackwell
2020
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1116325 http://hdl.handle.net/20.500.11937/86294 |
| _version_ | 1848764806041960448 |
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| author | Bunzli, Samantha O'Brien, P Klem, Nardia-Rose Incoll, I Singh, J Davaris, M Choong, P Dowsey, M |
| author_facet | Bunzli, Samantha O'Brien, P Klem, Nardia-Rose Incoll, I Singh, J Davaris, M Choong, P Dowsey, M |
| author_sort | Bunzli, Samantha |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Introduction: Fifty per cent of patients consent for total knee replacement (TKR) with
unrealistic expectations about what it involves and can achieve. A framework is
needed to help surgeons identify key knowledge gaps and misconceptions that can
be targeted during the informed consent process. In this qualitative study, we
explored knowledge gaps and misconceptions by asking patients to reflect on their
expectations along the TKR journey.
Methods: Eligible adults were ≥18 years, 12-month post-TKR and had completed a
validated expectations questionnaire pre-TKR as part of a joint replacement registry.
To capture a variety of perspectives, people with a range of pre-TKR expectation
scores were invited. In interviews, participants reflected on anticipated and actual
experiences and unexpected experiences they had along the way. Transcripts were
analysed through inductive thematic analysis. Recruitment ceased when thematic
saturation was reached.
Ethics Approval: Ethical approval for this study was granted by the St Vincent's Hospital Melbourne Ethics Committee (LRR 077/18).
Results: In the final sample (n = 20; 50% female; median age = 72 years; contralateral
TKR = 11), all participants described instances where their anticipated and actual
experiences diverged, including high expectations of improvements in pain/function
(pre-surgical optimism), lacking awareness about anaesthetic procedures (perioperative misunderstandings), feeling unprepared for the length of the recovery period
(post-operative misestimations) and trying to make sense of ongoing functional limitations (long-term misattributions).
Discussion and Conclusion: These findings are captured in a preliminary framework
of therapeutic misconception. Although future research is needed to test this framework prospectively in larger, more generalisable samples, surgeons can consider
these key knowledge gaps and misconceptions when consenting for TKR. |
| first_indexed | 2025-11-14T11:25:12Z |
| format | Journal Article |
| id | curtin-20.500.11937-86294 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T11:25:12Z |
| publishDate | 2020 |
| publisher | Wiley-Blackwell |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-862942021-11-19T08:15:45Z Misconceived expectations: Patient reflections on the total knee replacement journey Bunzli, Samantha O'Brien, P Klem, Nardia-Rose Incoll, I Singh, J Davaris, M Choong, P Dowsey, M Introduction: Fifty per cent of patients consent for total knee replacement (TKR) with unrealistic expectations about what it involves and can achieve. A framework is needed to help surgeons identify key knowledge gaps and misconceptions that can be targeted during the informed consent process. In this qualitative study, we explored knowledge gaps and misconceptions by asking patients to reflect on their expectations along the TKR journey. Methods: Eligible adults were ≥18 years, 12-month post-TKR and had completed a validated expectations questionnaire pre-TKR as part of a joint replacement registry. To capture a variety of perspectives, people with a range of pre-TKR expectation scores were invited. In interviews, participants reflected on anticipated and actual experiences and unexpected experiences they had along the way. Transcripts were analysed through inductive thematic analysis. Recruitment ceased when thematic saturation was reached. Ethics Approval: Ethical approval for this study was granted by the St Vincent's Hospital Melbourne Ethics Committee (LRR 077/18). Results: In the final sample (n = 20; 50% female; median age = 72 years; contralateral TKR = 11), all participants described instances where their anticipated and actual experiences diverged, including high expectations of improvements in pain/function (pre-surgical optimism), lacking awareness about anaesthetic procedures (perioperative misunderstandings), feeling unprepared for the length of the recovery period (post-operative misestimations) and trying to make sense of ongoing functional limitations (long-term misattributions). Discussion and Conclusion: These findings are captured in a preliminary framework of therapeutic misconception. Although future research is needed to test this framework prospectively in larger, more generalisable samples, surgeons can consider these key knowledge gaps and misconceptions when consenting for TKR. 2020 Journal Article http://hdl.handle.net/20.500.11937/86294 10.1002/msc.1475 http://purl.org/au-research/grants/nhmrc/1116325 Wiley-Blackwell restricted |
| spellingShingle | Bunzli, Samantha O'Brien, P Klem, Nardia-Rose Incoll, I Singh, J Davaris, M Choong, P Dowsey, M Misconceived expectations: Patient reflections on the total knee replacement journey |
| title | Misconceived expectations: Patient reflections on the total knee replacement journey |
| title_full | Misconceived expectations: Patient reflections on the total knee replacement journey |
| title_fullStr | Misconceived expectations: Patient reflections on the total knee replacement journey |
| title_full_unstemmed | Misconceived expectations: Patient reflections on the total knee replacement journey |
| title_short | Misconceived expectations: Patient reflections on the total knee replacement journey |
| title_sort | misconceived expectations: patient reflections on the total knee replacement journey |
| url | http://purl.org/au-research/grants/nhmrc/1116325 http://hdl.handle.net/20.500.11937/86294 |