"My bloody leg" - The lived experience of arthrofibrosis after total knee arthroplasty

Arthrofibrosis following total knee arthroplasty (TKA) is a recognised complication resulting in severe stiffness with limited options for treatment. To date, little is known about the lived experiences of those affected. This study aimed to understand the perceived impact of arthrofibrosis, the experience of the treatment pathway, and perceptions of barriers to optimal care.

Participants who had undergone elective TKA with postoperative arthrofibrosis, were recruited from three NHS orthopaedic units. All interviews were conducted using a semi-structured interview schedule, digitally recorded, and transcribed verbatim. Data were analysed using thematic analysis.

Fourteen patients were recruited. Four themes were developed from the data: Adjusting to Loss: Erosion of Function and Identity - the impact on function was overwhelming and significantly impaired social functioning. This resulted in self-reported adverse mental health outcomes. Seeking Clarity and Compassion: Navigating Communication with Healthcare Professionals - many participants described inconsistency in advice given post-TKA, particularly concerning exercise. Many felt that they had unmet needs related to their rehabilitation. Making Sense of a Stalled Recovery: The Quest for Answers, Solutions and Hope - significant emotional labour was invested in understanding what was happening to their knee. Commitment and Constraint: Navigating Rehabilitation in Everyday Life - participants described a commitment to post-operative exercise regimes; all had integrated exercises into daily activities but continued to face challenges.

The experience of arthrofibrosis after TKA is disruptive, distressing and frustrating. Future development of interventions and clinical pathways should ensure person-centred approaches that offer consistency and clarity of advice, particularly regarding exercise.

STUDY REGISTRATION NUMBER: NCT05459259.