Table 1.
Qualitative support for attributes included in the discrete choice questionnaire
| Attribute | Evidence of attribute inclusion, with pseudonym and surgery type | Levels | Rationale for levels |
| Number of operations | “There’s no way I want two more big operations now at my time of life. You do it all or not at all…I said there was no way I wanted two ops.” (Harriet, one-stage) “Of course, emotionally, you want it over and done with as soon as possible…but ultimately that has to be done in the correct way. There’s the tortoise and hare situation. There’s absolutely no point in rushing ahead if ultimately it’s going to fail.” (Maggie, two-stage) |
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Two types of revision surgery are currently provided in healthcare and involve either one or two operations. |
| Ability to engage in valued activities after new hip is fitted | “Fourteen months without a hip joint so it meant that I couldn’t drive a car, I couldn’t do anything that I’d been used to doing, playing golf or doing anything. Well, I gave up golf actually after the first revision.” (Don, two-stage) “But when I for example went to, on holiday recently and I had serious problems getting into the bath to stand in the shower. Because I, I couldn’t get in. And in a wet – on a wet surface and that, I’m very conscious of not falling in. I can’t afford to fall. So, pain I’ve got none, stiffness none. Physical function limitations, and that’s one of them.” (Rory, one-stage) “My aim has always been to get back on my feet as soon as I can, and to walk as good as I can, and that’s a big disappointment. I’m not where I think I should have been.” (Robert, two-stage) |
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Following revision surgery, the ability to engage in valued activities can be reduced in a major or somewhat more minor way. These levels capture variation in ability identified by patients. |
| Time taken after surgical treatment starts to return to normal activities | “I didn’t want to go 14 weeks with effectively one leg. What was worse was not knowing that I had to endure all of those weeks not knowing that I was ever going to get another hip joint back.” (Maggie, two-stage) “If I had known how hard it was going to be for her to walk in that interim six months, and if there seemed to have been a reasonable, or a good possibility that the infection would be nuked in a one stage, then that might have been a better outcome for her.” (Amelia, two-stage) “I would’ve thought that if you wanted to go back to work…you wouldn’t be very happy [having a 2-stage operation] because you wouldn’t be able to do nothing for those six weeks again. Then you’d have to go all through it again after three months of having it done. Six weeks is only a month and a half, and then in another month and a half you’re having it all done again.” (Jim, one-stage) |
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These time intervals demonstrate best approximations and a reflection of the need to ensure normal expectations of time taken for soft tissue recovery as expected by surgeons. 18 months is the maximum endpoint that surgeons would suggest for recovery time. |
| Antibiotic side effects | “…the nightmare on heavy antibiotics, toiletry wise. Now I’ve had to move into a, another bed. My wife and I are married 50 plus years, and I have to have my own room because I’m getting up in the night.” (Rory, one-stage) “…I stayed on antibiotics then for, for ever…and after the first [week of antibiotics] I was just dying. I just wanted to lie on the floor and die. I felt so sick. So ill.” (Lottie, two-stage) “I felt fine. When I was going to see the surgeon…They’d say, ‘How are you today?’ I’d say, ‘I feel fine, fit! [laughs] I feel well in myself, I eat well.’” (Ray, two-stage) |
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Antibiotics are an essential method of attempting to ensure the periprosthetic joint infection is treated and subsequently clear. For some patients, the impact of these antibiotics is significant, while for others there are less severe side effects. |