Jenny L Toonstra1, Dana Howell, Robert A English2, Christian Lattermann3, Carl G Mattacola. 1. Athletic Training Education Program, Department of Health and Sport Sciences, Salisbury University, MD. 2. Division of Physical Therapy, University of Kentucky, Lexington. 3. Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington.
Abstract
CONTEXT: The recovery process after autologous chondrocyte implantation (ACI) can be challenging for patients and clinicians alike due to significant functional limitations and a lengthy healing time. Understanding patients' experiences during the recovery process may assist clinicians in providing more individualized care. OBJECTIVE: To explore and describe patients' experiences during the recovery process after ACI. DESIGN: Qualitative study. SETTING: Orthopaedic clinic. PATIENTS OR OTHER PARTICIPANTS: Participants from a single orthopaedic practice who had undergone ACI within the previous 12 months were purposefully selected. DATA COLLECTION AND ANALYSIS: Volunteers participated in 1-on-1 semistructured interviews to describe their recovery experiences after ACI. Data were analyzed using the process of horizontalization. RESULTS: Seven patients (2 men, 5 women; age = 40.7 ± 7.5 years, time from surgery = 8.7 ± 4.2 months) participated. Four themes and 6 subthemes emerged from the data and suggested that the recovery process is a lengthy and emotional experience. Therapy provides optimism for the future but requires a collaborative effort among the patient, surgeon, rehabilitation provider, and patient's caregiver(s). Furthermore, patients expressed frustration that their expectations for recovery did not match the reality of the process, including greater dependence on caregivers than expected. CONCLUSIONS: Patients' expectations should be elicited before surgery and managed throughout the recovery process. Providing preoperative patient and caregiver education and encouraging preoperative rehabilitation can assist in managing expectations. Establishing realistic goals and expectations may improve rehabilitation adherence, encourage optimism for recovery, and improve outcomes in the long term.
CONTEXT: The recovery process after autologous chondrocyte implantation (ACI) can be challenging for patients and clinicians alike due to significant functional limitations and a lengthy healing time. Understanding patients' experiences during the recovery process may assist clinicians in providing more individualized care. OBJECTIVE: To explore and describe patients' experiences during the recovery process after ACI. DESIGN: Qualitative study. SETTING: Orthopaedic clinic. PATIENTS OR OTHER PARTICIPANTS: Participants from a single orthopaedic practice who had undergone ACI within the previous 12 months were purposefully selected. DATA COLLECTION AND ANALYSIS: Volunteers participated in 1-on-1 semistructured interviews to describe their recovery experiences after ACI. Data were analyzed using the process of horizontalization. RESULTS: Seven patients (2 men, 5 women; age = 40.7 ± 7.5 years, time from surgery = 8.7 ± 4.2 months) participated. Four themes and 6 subthemes emerged from the data and suggested that the recovery process is a lengthy and emotional experience. Therapy provides optimism for the future but requires a collaborative effort among the patient, surgeon, rehabilitation provider, and patient's caregiver(s). Furthermore, patients expressed frustration that their expectations for recovery did not match the reality of the process, including greater dependence on caregivers than expected. CONCLUSIONS:Patients' expectations should be elicited before surgery and managed throughout the recovery process. Providing preoperative patient and caregiver education and encouraging preoperative rehabilitation can assist in managing expectations. Establishing realistic goals and expectations may improve rehabilitation adherence, encourage optimism for recovery, and improve outcomes in the long term.
Authors: Karen Hambly; Vladimir Bobic; Barbara Wondrasch; Dieter Van Assche; Stefan Marlovits Journal: Am J Sports Med Date: 2006-01-25 Impact factor: 6.202