Evaluating recovery following periprosthetic fracture
Research type
Research Study
Full title
Evaluating recovery following periprosthetic fracture: a qualitative study of Understanding the patient experience and impact during the acute phase ‘after the fracture’
IRAS ID
309425
Contact name
Lewis Navarro
Contact email
Sponsor organisation
Lancashire Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 3 months, 0 days
Research summary
Hip and knee replacements are common in the NHS however some patients with joint replacements will go on to have a periprosthetic fracture after their operation. This is where the bone at or around the joint replacement fractures. Fracture around a joint replacement requires urgent treatment, usually an operation to stabilise or fix the fractured bone. Poor social health, also known as social deprivation, has been associated with a negative impact on physical and mental health outcomes in orthopaedic injuries and after surgery. Additionally, the impact on patient experiences following a periprosthetic fracture is not yet accounted for. To date, research has not drawn on social science theories to deepen our understanding of the impact of these types of fractures. Taking accounts of people from a variety of socioeconomic backgrounds who have had a periprosthetic fracture, their experiences of fracture, healthcare experience, and recovery is imperative in understanding the impact of major health and treatment events, particularly those with high levels of social deprivation.
The aim of this research is to develop an understanding of patients’ experience of the injury, surgery and post-operative care, impact of injury and subsequent treatment, what is important in their recovery and concerns and expectations for the future. The ambition of this project is to develop understanding of the patient experience and priorities to build on the existing evidence and inform the decision-making process to measure periprosthetic fracture recovery. It also aims to provide a basis for better targeted care and information for patients following any joint replacement surgery, particularly those from socially deprived backgrounds, to provide a basis for future targeted research to improve patient care pathways, and generally review quality of care and outcomes for these patients.Summary of study results:
Study Title: Exploring Patient Recovery Following a Femoral Periprosthetic Fracture: The Role of Socio-Economic Factors Who carried out the research?
This study was conducted by a researcher based at a major trauma hospital in the North-West of England. The study was part of a postgraduate academic project. There were no commercial sponsors or competing interests.
We would like to sincerely thank the patients who took part in this study. Their time, honesty, and openness helped us better understand what recovery really feels like after major injury.
Why was the research needed?
A femoral periprosthetic fracture is a serious complication that can happen after hip or knee replacement surgery. It often leads to a long recovery, pain, and difficulty returning back to everyday activities such as walking. This injury generally demonstrates worse outcomes than a hip fracture. We also know that people from different backgrounds don’t always have the same access to care or support, which can affect how well they recover. However, very little is known about patients’ personal experiences after femoral periprosthetic fractures, especially those from more deprived areas. This study aimed to address that gap.What were the main questions studied?
1. What is it like for patients recovering from a femoral periprosthetic fracture while in hospital?
2. Do patients from different socio-economic backgrounds experience recovery in different ways?
Where and when did the study take place?
The study took place in 2024 at an NHS major trauma hospital in the North-West of England. Interviews were conducted with patients while they were still in hospital.Who participated in the study?
Nine adult patients recovering in hospital after a femoral periprosthetic fracture took part. They were grouped according to where they lived, based on national measures of deprivation. This allowed the researcher to explore the effects of social and economic background.What happened during the study?
Participants took part in a one-on-one interview with the researcher. They were asked open questions about their recovery, how they felt physically and emotionally, what support they had, and how their recovery has been during their hospital stay. The responses were analysed to find common themes and differences.What were the results of the study?
The study found four key themes grouped under two main areas: the general recovery experience and the impact of socio-economic background.
• Most patients reported ongoing pain, problems with mobility, and emotional distress, such as anxiety or feeling a loss of independence.
• Many said that regaining independence — being able to move freely or go outside on their own — was their top recovery goal.
• Family support was essential. Those without strong social support, particularly from more deprived backgrounds, often struggled more.
• Patients from lower-income regions reported more delays, worse communication, and fewer resources available to help them recover whilst in hospital.How has this study helped patients and researchers?
This study gives a voice to patients recovering from a complex injury and highlights how social and economic inequality can influence health outcomes. It shows the need for:
• Better emotional and psychological access and support during recovery following injury, particularly whilst in hospital.
• Recovery goals that are personalised and focused on independence.
• More support systems (e.g., community peer support) for people without family or friend help.
• Clearer, more compassionate communication from healthcare staff particularly when awaiting surgery or in between physiotherapy or occupational therapy interactions.
Details of any further research planned
There is no current future research planned in this area however, future studies should involve a larger and more diverse group of patients, follow their recovery over a longer period (including after discharge), and test specific solutions such as improved communication or social support programs whilst in hospital.Where can I learn more about this study?
You can find more information by contacting the research team at lewis.navarro@lthtr.nhs.uk or by contacting the Lancashire Teaching Hospital’s Research Department. The study may be made available through an ‘open access’ site such as Research Gate though this is yet to be confirmed and carried out.REC name
South Central - Hampshire B Research Ethics Committee
REC reference
22/SC/0266
Date of REC Opinion
4 Oct 2022
REC opinion
Further Information Favourable Opinion