Enhanced Recovery in Orthopedics: A Prospective Audit of an Enhanced Recovery Program for Patients Undergoing Hip or Knee Arthroplasty.

Hip and knee arthroplasty are common 'surgical procedures. Enhanced recovery programs help reduce length of stay with good patient outcomes and satisfaction. An audit is described showing improved pain management, reduced nausea and vomiting, and quicker recovery through an interprofessional approach.

Living with severe osteoarthritis while awaiting hip and knee joint replacement surgery.

OBJECTIVES: To explore the lived experiences of patients with severe osteoarthritis (OA) of the hip or knee joint while awaiting joint replacement surgery. METHODS: An exploratory qualitative approach using phenomenology was adopted for the purpose of the study. Unstructured interviews were carried out on a sample of six patients who had been referred to the National Health Service waiting list for a primary hip or knee replacement. The participants were invited to share their experiences and concerns relating to how they were coping with end-stage OA of their hip or knee joint. Interviews were digitally recorded and transcribed verbatim. Narrative data were analysed using Giorgi's (1985) procedural steps to reveal themes which recurred in the participants' stories. RESULTS: Six themes emerged from the data, central to the experience of living with severe OA. They were: coping and living with pain; not being able to walk; coping with everyday activities; body image; advice and support available; and the effect of their disease upon family, friends and helpers. There were also a number of sub-themes associated with each major theme. CONCLUSIONS: This study suggests that there is an absence of generic support, guidance and information relating to the management of symptoms of OA for individuals awaiting hip and knee replacement surgery. Patients awaiting hip and knee joint replacement surgery often have difficulty in managing their symptoms. Support in general appears to be dependent on the availability of resources in the primary care setting. Potential patients who are fortunate to know or meet someone who has undergone a similar procedure learn from the experience of exchanging information between themselves, along with coping strategies in the management of their symptoms.