Coping with chronic periprosthetic joint infection after failed revision of total knee and hip arthroplasty: a qualitative study on patient’s experiences in treatment and healing
Vincent Tilo Krenn, Maria Sarah Bönigk, Andrej Trampuz, Martin Liebisch, Carsten Perka, Sebastian Meller
Abstract
Periprosthetic joint infections (PJI), along with the extensive medical and surgical interventions required for treatment, impose a substantial psychological burden on patients. Given the need for patients to adapt to long-term physical limitations and ongoing medical challenges.
Introduction
Total joint arthroplasties (TJA) of the hip and knee have markedly improved quality of life for millions by alleviating pain, restoring physical function and autonomy. In Germany, approximately 230,000 hip and 170,000 knee TJAs were performed in 2016, with an expected increase of 23% for hip and 45% for knee replacements by 2040 [1].
Materials and methods
Following ethics board approval (EA4/040/14), we conducted a qualitative interview study including 18 patients who underwent revision surgery after the diagnosis of PJI at our specialized department.
Results
Through a detailed examination of the data, we identified key areas of analytical interest. We started by constructing a thematic map that captured all relevant aspects in the broader context of individuals’ lived experiences with PJI.
Discussion
Our qualitative interview study explored the multifaceted nature of coping with chronic PJI within the context of treatment and healing. We found that patients develop a process-oriented mindset, which plays a central role in managing both the physical and emotional burdens of the disease.
Conclusions
From the patient’s standpoint, PJIs lead to irreversible life change that significantly affect their perceived quality of life and well-being independent of their infection status [7,25]. While the necessity of psychological support for PJI patients has been voiced before [6,9] and is strongly encouraged by our findings, there is currently no established framework for delivering this care.
Citation: Krenn VT, Bönigk MS, Trampuz A, Liebisch M, Perka C, Meller S (2025) Coping with chronic periprosthetic joint infection after failed revision of total knee and hip arthroplasty: a qualitative study on patient’s experiences in treatment and healing. PLoS ONE 20(3): e0319509. https://doi.org/10.1371/journal.pone.0319509
Editor: Adriana Calderaro, Universita degli Studi di Parma, ITALY
Received: June 17, 2024; Accepted: February 3, 2025; Published: March 12, 2025
Copyright: © 2025 Krenn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The data from this study involve patients with a rare condition (periprosthetic joint infection). This includes potentially identifying and sensitive patient information. Due to the detailed medical histories disclosed in the study, there is an increased risk of re-identification. Anonymized data from this study will be made available to bona fide researchers after approval from the Ethics Committee of Charité. This data will be handed over to the Research Data Management of Charité to ensure persistent and long-term data storage and availability. Researchers interested in accessing the data should contact the Ethics Committee at ethikkommission@charite.de. Data-sharing requests will be assessed on a case-by-case basis following the guidelines set by the Ethics Committee to ensure participant confidentiality.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
