Impact of Hospital Rehabilitation on Functional Outcomes and Quality of Life after Total Knee Arthroplasty

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

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The Effectiveness of Client-Centered Intervention With Telerehabilitation Method After Total Knee Arthroplasty

OTJR Occupation Participation and Health ◽

10.1177/15394492211038293 ◽

2021 ◽

pp. 153944922110382

Author(s):

Berkan Torpil ◽

Özgür Kaya

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Intervention Program ◽

Nottingham Health Profile ◽

Performance Measure ◽

Occupational Performance ◽

Significant Difference ◽

Total Knee

There is known to be a decrease in quality of life and perceived occupational performance and satisfaction following total knee arthroplasty (TKA). This study was planned to examine the effectiveness of a client-centered (CC) intervention with the telerehabilitation (TR) method on the quality of life, perceived occupational performance, and satisfaction after TKA. A total of 38 patients who had undergone TKA were randomly assigned to the CC and control groups. A 12-day intervention program was applied to the CC group. The Nottingham Health Profile (NHP) and Canadian Occupational Performance Measure (COPM) were applied before and after intervention. The 12-day intervention showed a strong effect on all parameters in the CC group ( p<.001). In the postintervention comparisons, a significant difference was found in favor of the CC group ( p < .001). CC interventions with the TR method can be used in post-TKA interventions.

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Improved knee biomechanics among patients reporting a good outcome in knee-related quality of life one year after total knee arthroplasty

BMC Musculoskeletal Disorders ◽

10.1186/s12891-017-1479-3 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 15

Author(s):

Josefine E. Naili ◽

Per Wretenberg ◽

Viktor Lindgren ◽

Maura D. Iversen ◽

Margareta Hedström ◽

...

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Knee Biomechanics ◽

Good Outcome ◽

Related Quality ◽

Total Knee ◽

One Year

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The influence of obesity on functional outcome and quality of life after total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.100b5.bjj-2017-1263.r1 ◽

2018 ◽

Vol 100-B (5) ◽

pp. 579-583 ◽

Cited By ~ 16

Author(s):

S. Xu ◽

J. Y. Chen ◽

N. N. Lo ◽

S. L. Chia ◽

D. K. J. Tay ◽

...

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Functional Outcome ◽

Knee Arthroplasty ◽

Obese Group ◽

Control Group ◽

Obese Patients ◽

Knee Score ◽

Total Knee

AimsThis study investigated the influence of body mass index (BMI) on patients’ function and quality of life ten years after total knee arthroplasty (TKA).Patients and MethodsA total of 126 patients who underwent unilateral TKA in 2006 were prospectively included in this retrospective study. They were categorized into two groups based on BMI: < 30 kg/m2(control) and ≥ 30 kg/m2(obese). Functional outcome was assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item Short-Form Health Survey.ResultsPatients in the obese group underwent TKA at a younger age (mean, 63.0 years, sd 8.0) compared with the control group (mean, 65.6 years, sd 7.6; p = 0.03). Preoperatively, both groups had comparable functional and quality-of-life scores. Ten years postoperatively, the control group had significantly higher OKS and MCS compared with the obese group (OKS, mean 18 (sd 5) vs mean 22 (sd 10), p = 0.03; MCS, mean 56 (sd 10) vs mean 50 (sd 11), p = 0.01). After applying multiple linear regression with the various outcomes scores as dependent variables and age, gender, and Charlson Comorbidity Index as independent variables, there was a clear association between obesity and poorer outcome in KSFS, OKS, and MCS at ten years postoperatively (p < 0.01 in both KSFS and OKS, and p = 0.03 in MCS). Both groups had a high satisfaction rate (97.8% in the control group vs 87.9% in the obese group, p = 0.11) and fulfillment of expectations at ten years (98.9% in the control group vs 100% in the obese group, p = 0.32).ConclusionAlthough both obese and non-obese patients have significant improvements in function and quality of life postoperatively, obese patients tend to have smaller improvements in the OKS and MCS ten years postoperatively. It is important to counsel patients on the importance of weight management to achieve a more sustained outcome after TKA. Cite this article: Bone Joint J 2018;100-B:579–83.

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