Examining the thoughts and experiences of repeatedly revised knee arthroplasty patients-a qualitative study.

Background: Knee arthroplasty is a common surgical treatment aimed at improving function and reducing pain. While generally successful, some patients experience complications or dissatisfaction, leading to a sequence of revision surgeries. These revisions are less successful than primary surgeries and carry risks. This study explores the impact on daily life of knee revisions for pain and poor knee function, patient motivations, and experiences, aiming to inform better decision-making.

Methods: A qualitative approach was used to investigate the experiences and thoughts of multiply revised knee patients with pain and poor function as dominating indications. We conducted 12 semi-structured single interviews with patients from three tertiary referral centres. Patients who had undergone two or more knee revisions, were cognitively competent and able to communicate in Danish were considered for inclusion. Patients who were revised because of infection or fracture were excluded from interviews.

Results: The patient conversations highlighted the daily struggle to achieve what each of the patients identified as a normal existence. The study identified one main theme: striving for a normal life and two sub-themes: (1) the desire for an active life and (2) the hope for improvement. The themes highlight the patients' wishes and thoughts in the period following surgery, what they find particularly challenging, and the underlying reasons for their willingness to undergo another revision. The results emphasize how patients' strong wish for a physically and socially active life free from pain, combined with their high hopes for improvement and faith in the biomedical model, drives a willingness to undergo additional surgeries despite previous suboptimal outcomes.

Conclusion: The study finds that patients' desire for a normal life and hope for improvement influence their decision to undergo revisions despite the potential risks. The pain impacting their daily lives and a strong trust in biomedical solutions leads them to consider further surgeries. The results of the study contribute to a better understanding of this patient group and can be used for informed decision-making regarding revision surgery, ensuring that the offered surgery aligns with the patients' needs.

Trial Registration: Our article does not report on health care intervention on human participants Clinical trial number: not applicable.