PJINEEDS
PJINEEDS
Functional and psychosocial needs of patients of working age during rehabilitation after periprosthetic infection of the knee or hip joint - development of a cross-border, supportive rehabilitation programme
Project team:
Amarins Koster, MSc, PhD cand.
Dr Dr Gesine H. Seeber
Prof. Dr Max Ettinger
A/prof. Dr Inge Akker-van der Scheek (UMCG, NL)
A/prof. Dr Martin Stevens (UMCG, NL)
Project description:
Millions of people around the world undergo joint replacement surgery every year. These are mostly hip or knee joint endoprostheses. In Germany, more hip and knee replacement operations are performed per capita than in many other European countries, such as the Netherlands. It is expected that the number of operations will continue to rise, partly because more and more operations are being performed on younger patients of working age. A significant proportion of patients currently fall into this group, and their share is expected to increase further in the coming years. As retirement age increases, many of these patients will have to cope with their artificial joints for a long time to come. Supporting a good recovery is therefore becoming increasingly important.
The most serious complication following hip or knee replacement surgery is periprosthetic joint infection (PJI), which affects 1-2% of patients. Given the increasing number of operations, this means a considerable number of people are affected. PJI can have a profound impact, comparable to a cancer diagnosis according to the literature: it is unpredictable, causes long-term functional and psychosocial limitations, affects daily life and leads to considerable uncertainty. The direct medical costs for an individual patient regularly exceed €100,000. In addition, there are indirect and intangible costs, such as loss of work and long-term disability.
Current PJI research focuses primarily on diagnostics, surgery and medication (antibiotics), while little attention is paid to medical and psychosocial rehabilitation. Exercise and targeted physiotherapy can improve balance, muscle strength, endurance and joint range of motion. It can also relieve pain and stiffness - benefits that are well documented in non-infected THA/TKA patients. Improved physical functioning also promotes psychological well-being and a faster return to work. However, evidence for effective rehabilitation pathways specifically for PJI patients is lacking and little is known about patients' perspectives on their functional and psychosocial needs. However, understanding these needs is essential to identify gaps in care and develop tailored aftercare programmes.
This cross-border project aims to develop a rehabilitation support programme for working-age patients with hip or knee PJI. Firstly, a systematic review of the existing literature on the biopsychosocial needs of PJI patients and possible strategies for coping with them will be conducted. Subsequently, a qualitative interview study will be conducted to investigate which functional and psychosocial needs of German and Dutch patients with hip or knee PJI remain unmet in the treatment and recovery process and whether these differ between countries. To capture the perspectives of healthcare professionals, a mixed-methods study consisting of an international online survey and interviews with healthcare professionals in the Netherlands, Germany, Norway and the United Kingdom will be conducted to assess current rehabilitation pathways and their suitability to fulfil patient needs.
Finally, a support programme will be developed in collaboration with patients, healthcare professionals and other stakeholders. This programme will then be tested in a pilot study to assess its feasibility and viability.