Psychological impact of prosthetic joint infections following total hip and knee arthrolasty

Abstract

Background. Prosthetic Joint Infection (PJI) is a devastating complication of total joint arthroplasty (TJA) with a relative survival rate worse than that of prostate cancer, melanoma, and breast cancer. This study explores the psychological impact of PJI of the hip and knee. Methods. Two separate studies were conducted - a qualitative study, using descriptive phenomenology, and a quantitative cross-sectional descriptive correlational study. Results. Participants reported substantial impact on independence, identity, and relationships. Functional limitations were associated with negative illness impact, anxiety, depression, and decision regret. Social support was an important moderator for negative illness impact, anxiety, and depression. Resilient coping was common, and linked to lower negative illness impact, lower intolerance of uncertainty, and lower depression scores. Poor surgical outcomes, including amputation and death, were common. Conclusion. The significant psychological impact of PJI may be moderated by stage of life. As in previous studies, loss of independence and identity, pain, burden, and emotional responses are impactful experiences in PJI, with social support playing a major role. Additionally, this study supports that decision regret is not as common as previously thought among those with PJI.