Influences on individuals with osteoarthritis in deciding to undergo a hip or knee joint replacement: A qualitative study

Purpose. Osteoarthritis (OA) of the hip and knee is one of the major long-term health conditions. At the end-stage of the disease, a hip or knee replacement may be necessary. Yet, deciding to undergo a total joint replacement (TJR) due to OA may be a difficult decision for individuals. We conducted a study to elucidate the factors that influence whether or not individuals with OA decide to undergo a hip or knee replacement. Method. A qualitative study nested within a longitudinal study (n = 268) that was exploring the management of OA. We interviewed a purposive sample of individuals (n = 27) with OA referred for consideration for TJR. Findings. Participants were aged 49 to 89 with hip or knee OA. Participants' decision-making was influenced by (1) symptoms, in particular pain and effect on physical functioning; (2) the opinion of others; (3) a weighing up of risks with benefits and (4) information sources. Conclusions. Participants with end-stage knee OA were less willing to undergo surgery than those with hip OA. There is a need to provide more treatment options and quality information and advice to individuals to enable informed decision-making.