scholarly journals Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Jesse C. Christensen ◽  
Andrew J. Kittelson ◽  
Brian J. Loyd ◽  
Michael A. Himawan ◽  
Charles A. Thigpen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Function ◽  
Physical Performance ◽  
Knee Arthroplasty ◽  
Pain Severity ◽  
Timed Up And Go ◽  
Total Knee ◽  
Function Subscale ◽  
Physical Function Subscale ◽  
Higher Functioning

Abstract Background Rates of total knee arthroplasty (TKA) procedures in younger, more medically complex patients have dramatically increased over the last several decades. No study has examined categorization of lower and higher functioning subgroups within the TKA patient population. Our study aimed to determine preoperative characteristics of younger patients who are lower functioning following TKA. Methods Patients were categorized into higher and lower functioning subgroups defined using a median split of 1) postoperative Timed Up and Go (TUG) test times and 2) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale scores. A split in age (65 years) was used to further classify patients into four categories: younger lower functioning, younger higher functioning, older lower functioning and older higher functioning. Measures from preoperative domains of health, psychological, physical performance and pain severity were examined for between-group differences. Results Comparing mean values, the younger lower functioning subgroup using the TUG had significantly weaker knee extensor, slower gait speed, higher body mass index and greater pain compared to other subgroups. The younger lower functioning subgroup using the WOMAC physical function subscale demonstrated higher pain levels and Coping Strategies Questionnaire-Catastrophizing Subscale scores compared to the older lower functioning subgroup. Conclusions Poorer preoperative physical performance and pain severity appear to have the largest influence on early postoperative TKA recovery in younger lower functioning patients relative to both younger and older higher functioning patients.

scholarly journals Neighbors-based prediction of physical function after total knee arthroplasty

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chong Kim ◽  
Kathryn L. Colborn ◽  
Stef van Buuren ◽  
Timothy Loar ◽  
Jennifer E. Stevens-Lapsley ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Function ◽  
Knee Arthroplasty ◽  
Prediction Interval ◽  
Optimal Number ◽  
Timed Up And Go ◽  
Average Width ◽  
Predictive Mean Matching ◽  
Total Knee ◽  
Prediction Approach

AbstractThe purpose of this study was to develop and test personalized predictions for functional recovery after Total Knee Arthroplasty (TKA) surgery, using a novel neighbors-based prediction approach. We used data from 397 patients with TKA to develop the prediction methodology and then tested the predictions in a temporally distinct sample of 202 patients. The Timed Up and Go (TUG) Test was used to assess physical function. Neighbors-based predictions were generated by estimating an index patient’s prognosis from the observed recovery data of previous similar patients (a.k.a., the index patient’s “matches”). Matches were determined by an adaptation of predictive mean matching. Matching characteristics included preoperative TUG time, age, sex and Body Mass Index. The optimal number of matches was determined to be m = 35, based on low bias (− 0.005 standard deviations), accurate coverage (50% of the realized observations within the 50% prediction interval), and acceptable precision (the average width of the 50% prediction interval was 2.33 s). Predictions were well-calibrated in out-of-sample testing. These predictions have the potential to inform care decisions both prior to and following TKA surgery.

scholarly journals Relationship between early physical activity after total knee arthroplasty and postoperative physical function: are these related?

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Daisuke Takamura ◽  
Kentaro Iwata ◽  
Tatsuya Sueyoshi ◽  
Tadashi Yasuda ◽  
Hideki Moriyama
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Physical Function ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Timed Up And Go ◽  
Total Knee

Abstract Background Physical activity is associated with physical function; however, the relationship between early physical activity after total knee arthroplasty (TKA) and postoperative physical function remains unclear. The purpose of this study was to evaluate the association of early physical activity after TKA with postoperative physical function. Methods Timed Up and Go test (TUG) of 47 patients was assessed preoperatively and at 10 days, 3 months, and 6 months postoperatively. Physical activity from the second to the ninth day after TKA was measured with accelerometer, and the correlation with pre- and postoperative physical function was evaluated . A multiple linear regression was used to predict TUG at 6 months after TKA. Results Postoperative physical activity correlated with preoperative TUG (ρ = −0.485, p < 0.001), TUG at 10 days (ρ = −0.675, p < 0.001), 3 months (ρ = −0.441, p < 0.01), and 6 months (ρ = −0.368, p < 0.05) after surgery. Multiple linear regression indicated that only the preoperative TUG was associated with TUG at 6 months. Postoperative physical activity was not an independent factor predicting TUG at 6 months after TKA. Conclusion Our study demonstrated that patients with better physical function have higher physical activity in the early postoperative period, whereas it does not affect physical function at 6 months after TKA. In the early postoperative period, increasing physical activity may not always be necessary to improve postoperative physical function. We also confirmed that preoperative physical function affects postoperative physical function. These findings may be beneficial in improving rehabilitation programs in the early postoperative period.

scholarly journals Comparison of the extent to which total hip and total knee arthroplasty restore patient-reported physical function

2016 ◽  
Vol 24 (11) ◽  
pp. 1875-1882 ◽  
Author(s):  
N.A. Glass ◽  
N.A. Segal ◽  
J.J. Callaghan ◽  
C.R. Clark ◽  
N.O. Noiseux ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Function ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Patient Reported ◽  
Total Knee

Results of Robotic-Assisted Versus Manual Total Knee Arthroplasty at 2-Year Follow-up

2021 ◽  
Author(s):  
Kevin B. Marchand ◽  
Rachel Moody ◽  
Laura Y. Scholl ◽  
Manoshi Bhowmik-Stoker ◽  
Kelly B. Taylor ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Function ◽  
Knee Arthroplasty ◽  
Postoperative Outcomes ◽  
Medical Complications ◽  
Womac Pain ◽  
Robotic Assisted ◽  
Surgical Data ◽  
Total Knee

AbstractRobotic-assisted technology has been developed to optimize the consistency and accuracy of bony cuts, implant placements, and knee alignments for total knee arthroplasty (TKA). With recently developed designs, there is a need for the reporting longer than initial patient outcomes. Therefore, the purpose of this study was to compare manual and robotic-assisted TKA at 2-year minimum for: (1) aseptic survivorship; (2) reduced Western Ontario and McMaster Universities Osteoarthritis Index (r-WOMAC) pain, physical function, and total scores; (3) surgical and medical complications; and (4) radiographic assessments for progressive radiolucencies. We compared 80 consecutive cementless robotic-assisted to 80 consecutive cementless manual TKAs. Patient preoperative r-WOMAC and demographics (e.g., age, sex, and body mass index) were not found to be statistically different. Surgical data and medical records were reviewed for aseptic survivorship, medical, and surgical complications. Patients were administered an r-WOMAC survey preoperatively and at 2-year postoperatively. Mean r-WOMAC pain, physical function, and total scores were tabulated and compared using Student's t-tests. Radiographs were reviewed serially throughout patient's postoperative follow-up. A p < 0.05 was considered significant. The aseptic failure rates were 1.25 and 5.0% for the robotic-assisted and manual cohorts, respectively. Patients in the robotic-assisted cohort had significantly improved 2-year postoperative r-WOMAC mean pain (1 ± 2 vs. 2 ± 3 points, p = 0.02), mean physical function (2 ± 3 vs. 4 ± 5 points, p = 0.009), and mean total scores (4 ± 5 vs, 6 ± 7 points, p = 0.009) compared with the manual TKA. Surgical and medical complications were similar in the two cohorts. Only one patient in the manual cohort had progressive radiolucencies on radiographic assessment. Robotic-assisted TKA patients demonstrated improved 2-year postoperative outcomes when compared with manual patients. Further studies could include multiple surgeons and centers to increase the generalizability of these results. The results of this study indicate that patients who undergo robotic-assisted TKA may have improved 2-year postoperative outcomes.

The Value of a Standardized Knee Functional Assessment in Predicting the Outcomes of Total Knee Arthroplasty

2021 ◽  
Author(s):  
Aline Miranda Ferreira ◽  
Rodrigo Salim ◽  
Fabricio Fogagnolo ◽  
Luciano Fonseca Lemos de Oliveira ◽  
Marcelo Riberto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Performance ◽  
Knee Arthroplasty ◽  
Performance Tests ◽  
Womac Function ◽  
Patient Reported ◽  
Dependent Variables ◽  
Physical Tests ◽  
Total Knee ◽  
Preoperative Predictors

AbstractQuestionnaires and physical tests are tools to determine the ability of an individual to perform tasks of the daily living. In our institution, a standardized knee performance evaluation including patient-reported outcome measures (PROMs) and physical performance tests has been applied to all patients undergoing total knee arthroplasty (TKA). Our goal was to identify which preoperative tools influence the outcomes of a TKA and if physical performance tests can be of value if used along with PROMs in predicting functional outcomes. Classification and regression tree was used to analyze which preoperative factors influence function after TKA. Western Ontario and McMaster Universities Arthritis Index (WOMAC) function (WOMAC-F), 6-minute walk test (6MWT), and timed up and go (TUG) test at the 12th postoperative month were the dependent variables. Age, body mass index, preoperative WOMAC function and pain score, muscle strength, 6MWT, and TUG test score were used as preoperative predictors of dependent variables. TUG ≤19.3 seconds and age <62 years were preoperative predictors of better scores in the WOMAC-F (5.5). Strength of extensor muscles of the nonoperated knee ≥99.43 N·m/kg and 6MWT> 328 m were preoperative predictors of a better postoperative 6MWT (499 m). TUG <12.3 seconds and 6MWT ≥421 m were preoperative predictors of better postoperative TUG (7.3 seconds). Preoperative performance in physical tests had an influence on postoperative outcome scores than PROMs after TKA. Less age, good muscular strength, greater capacity of walking, and smaller TUG times were associated with better outcomes.

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