title: It's not just a knee, but a whole life: A qualitative descriptive study on patients' experiences of living with knee osteoarthritis and their expectations for knee arthroplasty.
abstract: OBJECTIVE
  Knee arthroplasties are an increasingly common treatment for osteoarthritis (OA) and the main indication is pain. Previous research states, however, that 15-20% of the operated patients are dissatisfied and 20-30% have persistent pain after surgery. This study is aimed at describing patients' experiences of living with knee OA when scheduled for surgery and further their expectations for future life after surgery.
  
  
  METHODS
  We interviewed 12 patients with knee OA scheduled for arthroplasty, using semi-structured qualitative interviews. The interviews were recorded and transcribed verbatim and analyzed using qualitative thematic analysis.
  
  
  RESULTS
  Three categories were formulated with an overriding theme: "It's not just a knee, but a whole life." The three categories were "Change from their earlier lives," "Coping with knee problems," and "Ultimate decision to undergo surgery." The main finding was that knee OA affects the whole body and self, ultimately affecting the patients' lives on many levels. Further findings were that knee OA was considered to be the central focus in the participants' lives, which limited their level of activity, their ability to function as desired, their quality of life, and their mental well-being. Although surgery was considered to be the only solution, the expectations regarding the outcome differed.
  
  
  CONCLUSIONS
  The participants were forced to change how they previously had lived their lives resulting in a feeling of loss. Thus, the experienced loss and expectations for future life must be put into the context of the individual's own personality and be taken into account when treating individuals with knee OA. The experience of living with knee OA largely varies between individuals. This mandates that patients' assessment should be considered on individual basis with regard to each patient.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden; Josefina.nyvang@ki.se.
authors.forename: Josefina
authors.initials: J
authors.lastname: Nyvang
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden.|Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Hedström
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sissel Andreassen
authors.initials: SA
authors.lastname: Gleissman
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology*; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000523:psychology*; D010146:Pain / Q000209:etiology / Q000523:psychology; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology
keywords: Knee osteoarthritis; expectations; experiences; knee arthroplasty; pain; qualitative research