Patient experiences after surgically treated periprosthetic knee fracture in the distal femur – an explorative qualitative study

Abstract

Background

Periprosthetic knee fractures (PPKF) following total knee arthroplasty (TKA) are rare, but represents a potentially devastating complication. A significant gap in understanding patient experiences related to the surgical treatment and recovery process remains.

Objective

The aim of the study was to explore patients' experiences 3–4 months after surgical treatment of a PPKF in the distal femur.

Method

This exploratory qualitative study employed semi-structured, open-ended interviews with patients who had undergone surgical treatment for PPKF in the distal femur. Patients were recruited during hospitalization or at follow-up visits, with all approached individuals consenting to participate. Interviews were conducted three to four months post-surgery and data were analyzed thematically.

Results

Nine patients were interviewed between spring 2023 and spring 2024. The analysis yielded three themes: 1) Patient expectations of the recovery process, 2) Patient concerns – and consequently a desire for follow-up and information, and 3) The impact of recovery on independence and social life. Each theme was further illuminated with subthemes.

Conclusion

This study highlights the major challenges of recovering from PPKFs in the distal femur, including physical pain, psychological stress, and social disruption. Unlike elective TKAs, the sudden nature of PPKFs leaves patients unprepared for the lengthy recovery process, which often leads to frustration and isolation. Dependence on family for daily tasks can intensify the feeling of being a burden. To enhance patients’ recovery experiences and outcomes, clear communication and realistic expectations are essential in addressing these issues.