"I could have a proper ankle" - a qualitative study of patients' perceptions of total ankle replacement and ankle fusion surgery.
"I could have a proper ankle" - a qualitative study of patients' perceptions of total ankle replacement and ankle fusion surgery.
复制标题
DOI：
10.1186/s13047-022-00595-8
复制
发表时间：
2022-12-12
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
终末期踝关节骨关节炎通常会导致严重疼痛和功能受损。手术治疗包括全踝关节置换术（TAR）或踝关节融合术。缺乏关于哪种程序是最佳的确实证据。之前还没有研究彻底探索患者在整个 TAR/踝关节融合途径中的经历。本研究旨在通过探讨接受 TAR 或踝关节融合的患者对手术、教育、康复和结果的看法来解决这一差距。七名参与者是从英格兰北部的一个骨科中心特意挑选出来的（3 名女性，4 名男性）。参与者接受了未翻修的初次 TAR（n = 2）、需要翻修的 TAR（n = 3）或踝关节融合术（n = 2）。每个参与者都完成了一次半结构化访谈。采访内容均以数字方式记录、逐字转录并按主题进行分析。确定了三个主题，每个主题有两个子主题：决策（寻求帮助；手术选择）、支持的看法（信息/教育；临床支持）以及对个人的影响（个人情况和信仰；术后结果）。影响参与者重要活动的疼痛是他们决定寻求帮助的关键。参与者在 TAR 和踝关节融合之间的决定受到多种因素的影响。人们对融合后缺乏关节灵活性的担忧得到了强调，一些参与者认为 TAR 是“合适的脚踝”，可以使他们避免跛行。参与者从各种来源获得信息，大多数人认为他们的护理团队的教育不足。参与者的个人情况和信仰影响了他们的决策和对术后结果的看法。最后，虽然大多数参与者对他们的结果感到满意，但有些参与者仍然遇到严重的持续问题，例如行走困难和慢性疼痛。这项研究证明了提供有关 TAR 和踝关节融合的充分教育的重要性，以使患者能够做出明智的决定。大多数参与者认为他们接受的教育和临床支持并不能完全满足他们的需求。参与者的个人情况和信仰对他们的决策和对术后结果的看法有很大的影响，强调了个性化定制教育和临床支持的必要性。未来需要与更大样本的患者和其他主要利益相关者合作，制定基于共识的指南，为接受 TAR/踝关节融合的患者提供术前和术后支持。在线版本包含可在 10.1186/s13047-022-00595-8 获取的补充材料。
End-stage ankle osteoarthritis typically causes severe pain and impaired function. Surgical treatment involves total ankle replacement (TAR) or ankle fusion. Definitive evidence about which procedure is optimal is lacking. No previous studies have thoroughly explored patients’ experiences across the entire TAR/ankle fusion pathway. This study aimed to address this gap by exploring perceptions of surgery, education, rehabilitation and outcomes among patients who had undergone TAR or ankle fusion. Seven participants were purposively selected from an orthopaedic centre in northern England (3 females, 4 males). Participants had undergone primary TAR without revision (n = 2), TAR requiring revision (n = 3) or ankle fusion (n = 2). Each participant completed a single semi-structured interview. Interviews were digitally recorded, transcribed verbatim and analysed thematically. Three themes, each with two subthemes, were identified: decision-making (seeking help; surgical options), perceptions of support (information/education; clinical support) and impact on the individual (personal circumstances and beliefs; post-operative outcomes). Pain affecting participants’ valued activities was key to their decision to seek help. Participants’ decision between TAR and ankle fusion was influenced by multiple factors. Concerns regarding the lack of joint flexibility following fusion were highlighted, with some participants perceiving TAR as a “proper ankle” that would enable them to avoid limping. Participants obtained information from various sources, with most feeling that the education from their care team was inadequate. Participants’ individual circumstances and beliefs influenced their decision-making and perceptions of their post-operative outcomes. Finally, whilst most participants were pleased with their outcomes, some experienced substantial ongoing problems such as difficulty walking and chronic pain. This study demonstrates the importance of providing adequate education about TAR and ankle fusion to enable patients to make informed decisions. Most participants felt that the education and clinical support they received did not fully meet their needs. Participants’ personal circumstances and beliefs had a strong influence on their decision-making and perceptions of their post-operative outcomes, highlighting the need to personally tailor education and clinical support. Future work with a larger sample of patients and other key stakeholders is required to develop consensus-based guidelines on pre- and post-operative support for patients undergoing TAR/ankle fusion. The online version contains supplementary material available at 10.1186/s13047-022-00595-8.
登录
查看更多内容
影响因子：
4.1
作者：
Edwards, Paul K.;Mears, Simon C.;Barnes, C. Lowry
通讯作者：
Barnes, C. Lowry
影响因子：
3.2
作者：
Starks, Helene;Trinidad, Susan Brown
通讯作者：
Trinidad, Susan Brown
影响因子：
2.7
作者：
Conlin, Catherine;Khan, Ryan M.;Pinsker, Ellie B.
通讯作者：
Pinsker, Ellie B.
DOI：
10.1302/2633-1462.28.bjo-2021-0074.r1
发表时间：
2021-08
期刊：
Bone & joint open
影响因子：
--
作者：
Realpe AX;Blackstone J;Griffin DR;Bing AJF;Karski M;Milner SA;Siddique M;Goldberg A
通讯作者：
Goldberg A
影响因子：
1.3
作者：
Tai, Kerry;Vannabouathong, Christopher;Petrisor, Bradley A.
通讯作者：
Petrisor, Bradley A.