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Psychological health and recovery from total knee arthroplasty: a health services perspective (PhD Academy Award)
  1. Marie K March1,2
  1. 1 Department of Physiotherapy, Blacktown and Mount Druitt Hospitals, Western Sydney Local Health District, Blacktown, New South Wales, Australia
  2. 2 Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Marie K March, Department of Physiotherapy, Blacktown and Mount Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW 2148, Australia; Marie.March{at}

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What did I do?

I investigated the relationship between psychological health before total knee arthroplasty (TKA) and health service outcomes after TKA. I developed a psychologically informed physiotherapy intervention for patients before TKA, and pilot tested this intervention, evaluating patient outcomes, health service outcomes and implementation outcomes. I developed and tested a training intervention to upskill physiotherapists in key aspects of this psychologically informed physiotherapy intervention.

Why did I do it?

My clinical experience in a socially disadvantaged context was that patients with psychological symptoms recovered slowly and had longer hospital stays after TKA. This delayed patient flow through the hospital which impacted costs and patient care. However, little evidence explored these relationships, nor potential solutions. Understanding who is at risk for longer hospital stays, and interventions to minimise this risk, are important to empower clinicians to meet the needs of these patients, and for patients, carers and healthcare providers to have realistic expectations of recovery and hospital stays. There is greater urgency to understand this now as enhanced recovery pathways for TKA are implemented rapidly following COVID-19 disruptions to elective surgery, with pressure to provide a high volume of procedures in a short period of time.

Musculoskeletal research and practice has …

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  • Collaborators Professor Deborah Black, Dr Bijoy Thomas, Ms Amy Maitland, Dr Emma Godfrey, Dr Shruti Venkatesh, Dr Belinda Judd, Dr Jillian Eyles.

  • Contributors MKM was solely responsible for this manuscript.

  • Funding This work was supported by: Western Sydney Local Health District and University of Sydney Allied Health Kickstarter Research grant; Sydney Musculoskeletal Alliance Enabling Research Grant; Medical Research Future Fund Rapid Applied Research Translation grant; Westmead Charitable Trust Allied Health Career Development Grant.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.