title: Patients' decision making in total knee arthroplasty: a systematic review of qualitative research.
abstract: OBJECTIVE
  A patient-centred approach, usually achieved through shared decision making, has the potential to help improve decision making around knee arthroplasty surgery. However, such an approach requires an understanding of the factors involved in patient decision making. This review's objective is to systematically examine the qualitative literature surrounding patients' decision making in knee arthroplasty.
  
  
  METHODS
  A systematic literature review using Medline and Embase was conducted to identify qualitative studies that examined patients' decision making around knee arthroplasty. An aggregated account of what is known about patients' decision making in knee arthroplasties is provided.
  
  
  RESULTS
  Seven studies with 234 participants in interviews or focus groups are included. Ten themes are replicated across studies, namely: expectations of surgery; coping mechanisms; relationship with clinician; fear; pain; function; psychological implications; social network; previous experience of surgery; and conflict in opinions.
  
  
  CONCLUSIONS
  This review is helpful in not only directing future research to areas that are not understood, or require confirmation, but also in highlighting areas that future interventions could address. These include those aimed at delivering information, which are likely to affect the satisfaction rate, demand, and use of knee arthroplasties. Cite this article: Bone Joint Res 2015;4;163-169.
authors.affiliation: Warwick University, UHCW, Clifford Bridge Road, CV2 2DX, UK.
authors.forename: T
authors.initials: T
authors.lastname: Barlow
authors.affiliation: Warwick University, Warwick, UK.
authors.forename: D
authors.initials: D
authors.lastname: Griffin
authors.affiliation: Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, UK.
authors.forename: D
authors.initials: D
authors.lastname: Barlow
authors.affiliation: Warwick University, UHCW, Clifford Bridge Road, CV2 2DX, UK.
authors.forename: A
authors.initials: A
authors.lastname: Realpe