This grounded theory study describes the experience of undergoing total knee joint arthroplasty in the New Zealand public health system from the participants’ perspectives. The data sources were tape-recorded interviews, observation and published literature. There were nine participants, eight of whom underwent a relatively uncomplicated process, and one who had major complications. The analysis was based on the transcripts from seventeen hours of interviews, observation and extant literature.

It was found that patients managed the experience of total knee joint arthroplasty by an overarching psychosocial process, which was conceptualized as GETTING BACK TO THE FUTURE. The participants in the study considered they had a better future because of the surgery. The overarching basic psychosocial process comprised three main categories that are described separately but often occurred concurrently. The first category was enduring and described the way participants managed day-to-day living while they waited until their condition was severe enough to warrant surgery. The second category was named thinking twice. This described how patients adjusted to disability and recovery from surgery by problem solving. The third category keeping faith, reflected the trust and confidence participants exhibited in themselves, in the health professionals who cared for them, and even the public health system.

The study has provided insight into the patient perspective of undergoing total knee joint arthroplasty. One of the major discoveries was the person in context beyond the hospital stay. The findings reinforced the value of multidisciplinary education and pre-habilitation preparation for surgery. In addition, the findings suggest there is a need for a post-operative home visit within a few days of discharge by an orthopaedic team member. Further research to explore undergoing total knee joint arthroplasty from the perspective of patients with rheumatoid arthritis and patients who develop significant complications following surgery is recommended.