The impact of different health service systems upon patient outcomes after total knee arthroplasty: An exploration of the patient journey after total knee replacement

Apply and key information

This project is funded by:

Department for the Economy (DfE)
Vice Chancellor's Research Scholarship (VCRS)

Summary

Osteoarthritis (OA) affects over 595 million people globally, making it the 11th leading cause of disability. It primarily impacts weight-bearing joints, especially the knee. In the UK, approximately 5.4 million people suffer from knee OA. As a painful and progressive condition, knee OA (KOA) significantly burdens individuals and severely impacts their quality of life.

When conservative management is ineffective or unsuitable, Total Knee Arthroplasty (TKA) is recommended. The NHS performed 67,193 TKA procedures in 2023, projected to rise to 118,503 by 2030. While many patients report positive outcomes post-TKA, evidence indicates that some experience poor responses, with 20% suffering from chronic pain.

Clinical pathways, access to care, and long-term outcomes post-surgery vary across populations and NHS regions. This variability may stem from factors such as access to healthcare, public versus private funding, socioeconomic influences, funding shortages, increasing wait times, and an aging population. There is limited research comparing factors that contribute to poorer outcomes post-TKA related to quality care indicators and investigating patients' lived experiences in different healthcare systems. This study aims to explore the differences in healthcare pathways and their impact on patient experiences.

Aim: To explore differences in pre-operative and post-operative healthcare pathways and their impact on patient outcomes across healthcare systems.

Objectives:

Examine how healthcare pathways for TKA patients in the US, Northern Ireland, and England differ.

Investigate whether differences in healthcare systems correlate with recorded outcomes.

Assess pre-operative expectations and post-operative satisfaction across jurisdictions.

Methodology:

Focus groups with key stakeholders to evaluate differences in pathways.

Examination of objective and patient-reported outcomes from existing datasets.

Multi-jurisdictional examination of patients’ lived experiences using mixed methods.

This PhD will build on ongoing research predicting TKA outcomes and contribute to collaborative studies with colleagues in Birmingham University and Thomas Jefferson University.

AccessNI clearance required

Please note, the successful candidate will be required to obtain AccessNI clearance prior to registration due to the nature of the project.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

Experience using research methods or other approaches relevant to the subject domain

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

Masters at 65%
Experience using research methods or other approaches relevant to the subject domain
Relevant professional qualification and/or a Degree in a Health or Health related area

Equal Opportunities

The University is an equal opportunities employer and welcomes applicants from all sections of the community, particularly from those with disabilities.

Appointment will be made on merit.

Funding and eligibility

This project is funded by:

Department for the Economy (DfE)
Vice Chancellor's Research Scholarship (VCRS)

Our fully funded PhD scholarships will cover tuition fees and provide a maintenance allowance of £19,237 (tbc) per annum for three years (subject to satisfactory academic performance). A Research Training Support Grant (RTSG) of £900 per annum is also available.

These scholarships, funded via the Department for the Economy (DfE) and the Vice Chancellor’s Research Scholarships (VCRS), are open to applicants worldwide, regardless of residency or domicile.

Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Due consideration should be given to financing your studies.