{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:48:14Z","timestamp":1791377294222,"version":"4.3.2"},"reference-count":22,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,10,20]]},"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Around 1% of patients who have a hip replacement have deep prosthetic joint infection (PJI) afterwards. PJI is often treated with antibiotics plus a single revision operation (1-stage revision), or antibiotics plus a 2-stage revision process involving more than 1 operation. This study aimed to characterise the impact and experience of PJI and treatment on patients, including comparison of 1-stage with 2-stage revision treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative semistructured interviews with patients who had undergone surgical revision treatment for PJI. Patients were interviewed between 2\u2005weeks and 12\u2005months postdischarge. Data were audio-recorded, transcribed, anonymised and analysed using a thematic approach, with 20% of transcripts double-coded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Patients from 5 National Health Service (NHS) orthopaedic departments treating PJI in England and Wales were interviewed in their homes (n=18) or at hospital (n=1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>19 patients participated (12 men, 7 women, age range 56\u201388\u2005years, mean age 73.2\u2005years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants reported receiving between 1 and 15 revision operations after their primary joint replacement. Analysis indicated that participants made sense of their experience through reference to 3 key phases: the period of symptom onset, the treatment period and protracted recovery after treatment. By conceptualising their experience in this way, and through themes that emerged in these periods, they conveyed the ordeal that PJI represented. Finally, in light of the challenges of PJI, they described the need for support in all of these phases. 2-stage revision had greater impact on participants\u2019 mobility, and further burdens associated with additional complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Deep PJI impacted on all aspects of patients\u2019 lives. 2-stage revision had greater impact than 1-stage revision on participants\u2019 well-being because the time in between revision procedures meant long periods of immobility and related psychological distress. Participants expressed a need for more psychological and rehabilitative support during treatment and long-term recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009495","type":"journal-article","created":{"date-parts":[[2015,12,8]],"date-time":"2015-12-08T20:29:10Z","timestamp":1449606550000},"page":"e009495","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":156,"title":["Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3185-1599","authenticated-orcid":false,"given":"Andrew J","family":"Moore","sequence":"first","affiliation":[{"name":"Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley W","family":"Blom","sequence":"additional","affiliation":[{"name":"Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R","family":"Whitehouse","sequence":"additional","affiliation":[{"name":"Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Gooberman-Hill","sequence":"additional","affiliation":[{"name":"Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Southmead Hospital, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,12,7]]},"reference":[{"key":"2025121513582012000_5.12.e009495.1","unstructured":"National Joint Registry for England, Wales and Northern Ireland. 11th Annual Report. 2014. http:\/\/www.njrreports.org.uk\/hips-all-procedures-activity\/H03v2NJR (accessed 23 Jun 2015)."},{"key":"2025121513582012000_5.12.e009495.2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B7.14095"},{"key":"2025121513582012000_5.12.e009495.3","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B7.17150"},{"key":"2025121513582012000_5.12.e009495.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra040181"},{"key":"2025121513582012000_5.12.e009495.5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1302\/0301-620X.59B3.893507","article-title":"The natural history of the patient with an infected total hip replacement","volume":"59","author":"Hunter","year":"1977","journal-title":"J Bone Joint Surg Br"},{"key":"2025121513582012000_5.12.e009495.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2004.00928.x"},{"key":"2025121513582012000_5.12.e009495.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2010.03.017"},{"key":"2025121513582012000_5.12.e009495.8","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1177\/230949900801600115","article-title":"Quality of life after infection in total joint replacement","volume":"16","author":"Cahill","year":"2008","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"2025121513582012000_5.12.e009495.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b1773"},{"key":"2025121513582012000_5.12.e009495.10","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1016\/j.arth.2014.04.013","article-title":"Management of periprosthetic joint infection after total hip arthroplasty using a custom made articulating spacer (CUMARS); 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