ArticleBMJ open2026
Symptom experience of patients after total knee arthroplasty in China: a longitudinal qualitative study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTotal knee arthroplasty (TKA) is a common and effective procedure for end-stage knee osteoarthritis, yet patients frequently encounter a complex and dynamic symptom experience during the initial period that can significantly impact their rehabilitation and quality of life. This study aimed to explore the symptom experience of patients within 6 weeks after TKA.
designA longitudinal qualitative study using semi-structured interviews.
settingThis study was conducted in an orthopaedics department of a tertiary general hospital in China.
participantsInterviews were conducted with 16 patients at 3-5 days postoperatively, 14 patients at 2 weeks postoperatively and 10 patients at 6 weeks postoperatively.
methodsData were collected between July 2024 and November 2024. A purposive sampling method was used to recruit patients. Data were analysed using directed content analysis, with data collection and analysis performed concurrently.
resultsThree themes and nine subthemes were identified: (1) symptom perception, including perceived complexity of symptoms, self-identity conflict due to functional limitations, activation of negative emotions and psychological adaptation and interaction and amplification effects among symptoms; (2) symptom evaluation, characterised by the dynamic cognitive reframing of symptom meaning, self-blame tendency and internalisation of responsibility and interference from social and medical information; (3) symptom coping, involving dynamic evolution of active coping strategies and self-efficacy reinforcement, temporal characteristics of passive coping patterns and rehabilitation barriers.
conclusionThe symptom experience of patients who had TKA is complex and dynamic. Healthcare providers should implement tailored interventions based on patients' symptom experiences at different stages to facilitate symptom management, alleviate distress and negative emotions and improve quality of life.
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