title: Return to work after knee replacement: a qualitative study of patient experiences.
abstract: OBJECTIVE
  An increasing number of patients in the working population are undergoing total knee replacement (TKR) for end-stage osteoarthritis. The timing and success of return to work is becoming increasingly important for this group of patients with social and economic implications for patients, employers and society. There is limited understanding of the patient variables that determine the ability to return to work. Our objective was (from the patient's perspective) to gain an insight into the factors influencing return to work following knee replacement.
  
  
  METHODS
  This qualitative study was undertaken in a secondary-care setting in a large teaching hospital in the north of England. Semistructured interviews were carried out with 10 patients regarding their experiences of returning to work following TKR.
  
  
  RESULTS
  Interviews were transcribed and analysed using a qualitative thematic approach to identify the factors influencing return to work from the patient's perspective.
  
  
  RESULTS
  Three themes were identified that influenced the process of return to work, from the patient's perspective. These were delays in surgical intervention, limited and often inconsistent advice from healthcare professionals regarding return to work, and finally the absence of rehabilitation to optimise patient's recovery and facilitate return to work.
  
  
  CONCLUSIONS
  There is currently no consistent process to optimise return to work for patients of working age after TKR. The impact of delayed surgical intervention, limited advice regarding return to work, and a lack of work-focused rehabilitation, all contribute to potential delays in successful return to work. There is a need to change the focus of healthcare provision for this cohort of patients, and provide a tailored healthcare intervention to optimise patient outcomes.
authors.affiliation: Clinical Academic Unit, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Bardgett
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Lally
authors.affiliation: Department of Orthopaedic Surgery, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Ajay
authors.initials: A
authors.lastname: Malviya
authors.affiliation: Department of Orthopaedic Surgery, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: David
authors.initials: D
authors.lastname: Deehan
mesh_terms: D000328:Adult; D019645:Arthroplasty, Replacement, Knee; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D020127:Recovery of Function; D062707:Return to Work / Q000706:statistics & numerical data*
keywords: QUALITATIVE RESEARCH
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