Engagement in activities following total joint replacement


Spring is on its way and many of our elves are hoping to get out and about and enjoy the sunshine. One of our elves has recently had a knee replacement and is keen to get back to their active ways! They wonder if they will be able to do this and wanted to know ‘why people do or do not engage in activities following joint replacement?’

We found a review in Osteoarthritis and Cartilage that’s just up their street! And it’s a longitudinal study, so we get to find out what happened over time like a story!

Here’s what they did

The authors interviewed 29 patients who experienced a total hip or knee joint replacement  using open-ended, semi-structured interview questions. The researcher met with them three times: before the surgery, 8 and 18 months post total joint replacement. They wanted to explore why people do or do not engage in activities following total joint replacement. They searched for thematic patterns in the data using the constant comparison approach and grounded theory.

Here’s what they found

  • Rates of return to activities were incredibly varied.
    • Five themes emerged in the data that help us understand this variability.
    • losses due to OA prior to surgery;
    • the experience of total joint replacement surgery;
    • issues with multi-morbidity, including mental health and multiple symptomatic joints;
    • social context
    • fears around the new joint.
  • Interestingly, the authors found that it wasn’t just medical factors that accounted for why people did or did not return to activity. Socio-cultural factors; things like friendships and social circles, geography, were just as important in determining whether someone participated in activity following total joint replacement.

The authors suggested that many things impact on return activity following total joint replacement and it’s really important not to forget that.

The authors concluded

Following total joint replacement people have varied experiences impacting on subsequent participation in activity. They suggest total joint replacement may influence someone’s identity and lifestyle and these things in turn are barriers to ‘return to normal’ or business as usual.


Social factorssuch as friendships and social circles and geography are just as important!


The authors have some solutions to this problem and suggest more personalised interventions are needed to facilitate people’s return to a healthy lifestyle post total joint replacement.

The Musculoskeletal Elf’s view

The Musculoskeletal Elf

What an interesting study! Quantitative research suggests people do not necessarily increase levels of activity post-total joint replacement. This paper explores some of the reasons why people do or do not return to activity.   It’s interesting that not all of the reasons for non-participation are due to medical factors or pain; social factors are just as important!

Other studies also show people’s social networks and social context are incredibly important in the uptake of activity.

What do you think?

  • Is this what you might have expected?

Send us your views on this blog and become part of the ever expanding Musculoskeletal Elf community. Post your comment below, or get in touch via social media (FacebookTwitterLinkedInGoogle+).


  • Webster F, Perruccio A.V, Jenkinson R., Jaglal S, Schemitsch E, Waddell JP, Venkataramanan V, Bytautas J, Davis AM, Understanding why people do or do not engage in activities following total joint replacement: a longitudinal study, Osteoarthritis and Cartilage (2015), doi: 10.1016/j.joca.2015.02.013.
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Ali Rowsell

I am a research fellow at the University of Southampton, Faculty of Health Sciences working as a qualitative researcher on a longitudinal study, interviewing patients with Parkinson’s disease as part of a larger trial called PDSAFE. I graduated in 1994 with a BA (Hons) in Social and Educational Studies and Art and a BSc (Hons) Psychology in 2009. I have an MPhil in Applied Social Science. I’m studying for a PhD and looking at ‘Making online health interventions engaging for people with varying levels of education and health literacy’.

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