Research Internship with the Person-Centred Complex Care (PCCC) theme

Background: Femoral Periprosthetic Fractures (PPF) are complex fractures in or around a previous orthopaedic implant such as a total hip or total knee replacement. There is an ever-increasing incidence of between 5-18% of femoral PPF annually with higher instances in populations with higher social deprivation. Compared to other orthopaedic injuries, periprosthetic fractures are associated with: prolonged hospital length of stay, poor quality of life measures, poor physical functional outcomes, high mortality and disability rates, and post-operative complications. Poor social health, also known as social deprivation, has been associated with a negative impact on physical and mental health outcomes in orthopaedic injuries following surgery. However, its impact on patient experiences following a periprosthetic fracture is not yet accounted for, namely: experience and impact of injury, experience of surgery and post-operative care, and what is important during patient recovery.

Research aims and objectives:
How do patients experience recovery from a periprosthetic fracture and what is important to them?
• to explore patient experience of recovery following a periprosthetic fracture over the course of a year following their injury.
Does socio-demographic deprivation influence patient experience and priorities during their recovery?
• to explore if there is variation between population socioeconomic status and the experience of what is considered important in recovery from periprosthetic fracture.

Methods: A qualitative phenomenological approach will be used, involving interviews with patients at a major trauma hospital in the North West of England. Semi-structured interviews with 20 patients, aged between 18–100 years, who have radiographic evidence of femoral PPF, will be conducted post-operatively and prior to discharge from hospital.

Patient and public involvement: Public advisors provided input to ensure the research question is relevant and the study design is appropriate, with the design being subsequently changed as a result. Interview topic guides were developed in collaboration with patients with lived experience.

Potential impact: This project aims to help provide basis for better targeted care and education for patients following any femoral orthopaedic surgery, particularly those from increased socially deprived backgrounds, and provide basis for future targeted research to improve patient care pathways for this cohort.

Links:
• ARC NWC Internship Showcase Poster
• Newsletter (March 2023)

For more information, contact lewis.navarro@lthtr.nhs.uk