The bumpy road to recovery: older adults’ experiences during the first year after hip replacement surgery - a longitudinal qualitative study

Abstract

Background: Half of the older adult population worldwide is expected to undergo surgery at least once in their lifetime, with hip and knee replacements being among the most common procedures. Recovery after surgery is particularly difficult for older adults because of age-related physiological changes, an increased risk of complications, and the need for self-management at home following brief hospital stays. Emotional challenges such as fear, anxiety, and loss of independence further impact recovery, yet these aspects are often overlooked in clinical care. Currently, there is a lack of understanding of how older adults experience postoperative recovery after hip replacement surgery over time. Objective: To explore the experiences of recovery over time among older adults during the first year after hip replacement surgery. Methods: This descriptive longitudinal qualitative study included 30 older adults scheduled for hip replacement surgery at a university hospital in Sweden. Semistructured interviews were conducted twice, at fourteen days and one year after surgery. The data were analyzed using qualitative content analysis, following a Pattern-Oriented Longitudinal approach to inductively describe experiences over time. Results: The analysis resulted in one overarching theme: “the bumpy road to recovery” and three categories: physical challenges post-surgery, cognitive and emotional changes after surgery, and social and daily life adjustments. Recovery involves a balance between resting, managing symptoms, and regaining strength. For many, recovery involves physical, emotional, and cognitive challenges that feel discouraged. Conclusion: This study highlights the complex and individualized recovery process after hip replacement surgery. The participants navigated physical, cognitive, emotional, and social challenges and reached a new stable state after surgery. Balancing rest and activity, managing symptoms, and maintaining social connections are key factors for successful recovery. Preoperative education and support from healthcare providers and family members are vital in improving the recovery process for older adults.