Table 2 Themes and supporting quotations for interpretation of baseline interviews

Causation:

"...I think it's just wear and tear. I think it's just accepted that you're going to get these things as you get older." Cathy

"...I was very athletic when I was young, and you know yourself with the athletes the injuries they get affects them later in life." Celia

"...My daughters have trouble with their knee now as well, don't know if it's inheritance...my granddad suffered with it, my mother's troubled with it." Sandra

"...Well as I say, I need to lose weight...Well I mean there must be a lot of pressure on my knees as well, because I am overweight." Alan

Impact:

"...It's very tiring walking round shops...Some days I just sit here most of the time because its too painful too painful to move..." Rachel

"...Getting out of bed, getting going, turning over in bed, waking up in the night...getting in and out of the car is a nightmare..." Geraldine

"...I don't have a bath. I can't get up and down...I stand in the bath and wash down." Doris

"...I'm good at going up stairs, it's the coming down I have difficulty with." Veronica

"...I'm limited now, I can't go out as often as before, you know." Sandra

"...It alters your life...it swings your life right round, it restricts you..." Deirdre

"...Well there's hardly a good day you know. I mean I just make the best of it. I don't try to you know, let it get me down. Although I have pain, I'll try and do what I can do you know rather than to just say 'I am in pain I cant do that'..." Ernest

"...my daughter has to be with me to have a bath...I can't move, I can't push my legs down from my knees, they won't function...I can't do shopping...my daughter does it all, yeah. You know, I mean she's ever so good to me...She does things, she does this of a morning before she goes to work..." Stella

"... [inability to do gardening] makes me mad at times, cos I feel frustrated about it. I know there's masses of things that want to be done out there, I just haven't got the energy to do them...It makes you feel older." Rachel

"...I'm very upset with myself cos, you know, when you're used to being mobile and able to do things for yourself, now you have to depend on people to do it, it's not very nice is it?...It's embarrassing. Like [at a dinner and dance] I sat down and had the dinner, and when I was to get up I couldn't move. I was so embarrassed and people looking at me." Mary

Management:

"... [participants GP] never said anything, that's why I have always thought it's not worth bothering about. He's not bothered so I am not bothered..." Betty

"...I don't want too many tablets in me... I can try and bear pain myself." Sandra

"...I do really try to keep off drugs because, you know, I mean I think that they all have side effects." Donald

"I'm waiting for a knee replacement, cos I find it very difficult to get around, you know...I'm hoping the operation will correct it." Mary

"...I'd have to be a lot worse than what I am now I think...well I mean if I've gone for thirty years I can go on for a few more." Veronica

"...I don't want knee surgery, I've seen it happen; I've seen people have it very successfully and I've seen it be a disaster." Geraldine

"...I get the pain and there is nothing that can be done about it..." Betty

"...I'm questioning whether exercise might exacerbate or ease it. I really don't know." Donald

"...I got a little bit frightened of doing exercise because I don't know what exercises will be detrimental to the knee or advantageous to it." Derek

"...I think if you lose weight it keeps one off the tablets..." Geraldine

Prognosis:

"...I hope not permanent." Bernard

"...I think probably it might get worse because it has been getting worse over the years." Mary

"...I think, having to sit in one of those [wheelchairs]...I wouldn't want to do it, I don't want to get to that stage..." Rachel

"...nothing will stop it getting worse I'm sure...if you have a replacement thing well alright that'll be alright but I mean otherwise they [his knees] just go on getting older..." Jack