My Knee Plan

Theme Surgical and orthopaedic innovation

Workstream Interventions to improve patient outcomes after surgery

Status: This project is ongoing

A surgeon examines his patient's knee before surgery

During this project we will ask researchers, healthcare professionals and patients to co-produce a care plan for patients undergoing total knee replacement (TKR). Our aim is to develop a plan that can then be delivered to patients before and after surgery by a named contact.

Over 110,000 TKRs are performed in the UK every year. One in five patients are dissatisfied with their outcome and/or have chronic pain after surgery. Some patients feel abandoned after their surgery and have expressed a need for more advice and support. About 5 per cent of patients will have their operation cancelled at short notice, usually for avoidable medical reasons, which can have a negative effect on quality of life and relationships with healthcare professionals.

Continuity of care (care consistently delivered by a named contact) is important for patient satisfaction and has been shown to improve outcomes in several clinical specialties. Using this approach could help us improve patient outcomes and satisfaction. This is because we would be providing them with tailored treatment, support and education. However, it is an approach that has not been evaluated within orthopaedics.

We will ask up to fifteen researchers, clinicians and patients to collaborate on producing the plan. They will meet regularly throughout the project to review and discuss the data we collect. The results of these discussions will inform the design of the care plan.

We will:

  • Review the literature to look for previous evaluations of interventions that took place before and after surgery for patients undergoing primary TKR
  • Collect data from three NHS hospitals to identify medically avoidable reasons why TKR operations are cancelled and inform how a named contact can contribute to medical optimisation and help manage a patient’s expectations
  • Interview 20 patients and four focus groups with healthcare professionals to explore the needs and preferences of patients undergoing TKR and the healthcare professionals who provide care for these patients
  • Collate our findings and present them to a panel of at least 50 patients and 50 healthcare professionals for review