The impact of adverse events following total hip replacement

Student thesis: Doctoral ThesisDoctor of Philosophy (PhD)


Total Hip Replacement (THR) is a successful procedure to treat chronic hip pathology. An adverse event (AE) following THR may have devastating consequences for the patient, resulting in significantly reduced quality of life and function. The psychosocial and physical impact of AEs is not yet known.

This research aims to develop an in-depth understanding of the psychosocial and physical impact of AEs on patients following THR, with specific reference to post-operative periprosthetic femoral fracture (PPFF), post-operative dislocation and prosthetic joint infection (PJI).

Patient perception of AEs and the impact on outcome was investigated in a cohort study of patients undergoing THR. Using thematic analysis, from a social constructionist perspective, qualitative in-depth interviews with patients who experienced PPFF and dislocation were analysed. Results were compared to findings from a thematic synthesis of studies relating to PJI to develop an understanding of the impact and experiences of AEs after THR.

AEs significantly impact on many aspects of patients’ lives. Patient perception of an AE may be as impactful on outcomes as those with confirmed AEs. The occurrence of an AE represents a significant and unexpected disruption to patients’ recovery after THR that impacts on patients’ physical and psychosocial wellbeing. Patients experience lack of mobility and restriction to their usual activities and support from family and social networks is integral to patients’ recovery. There is a complex interplay between fear and lack of confidence, and adaptation after AEs. Patients particularly fear recurrence of AEs and make adaptations in their lived world to avoid this. Patients’ experiences of healthcare resources varied amongst AEs but patients value information at all timepoints in their treatment and express a need for improved access to healthcare resources, physiotherapy and support.
Date of Award28 Sep 2021
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorAndrew J Moore (Supervisor), Vikki Wylde (Supervisor) & Michael R Whitehouse (Supervisor)

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