Abstract
Objectives
(1) To determine evidence-based guidance for the length of time to return to specific
valued functional and leisure activities after knee arthroplasty (KA). (2) To determine
what patients feel are the most important functional or leisure activities to recover
after KA. (3) To collect information about patients’ expectations and compare them
to the actual time it takes to return.
Design
Prospective longitudinal cohort observational survey.
Setting
Specialist orthopedic hospital.
Participants
Patients (N=99) with osteoarthritis or rheumatoid arthritis (mean=69.9y [range 44-88])
listed for total knee arthroplasty (TKA) or unicompartmental knee arthroplasty.
Interventions
Not applicable.
Main Outcome Measure
Valued activities list (VAL) used to select activities patients expect to return to
and report the actual time taken to return.
Results
Participants in unicompartmental knee arthroplasty group returned to the 6 most popular
valued activities (walking >1km, stair climbing, housework, driving, gardening, and
kneeling) 8%-33% more quickly than TKA group, and they were satisfied with performing
these activities sooner on average (4%-18%) than the TKA group. The percentage of
participants satisfied at 12 months postsurgery ranged from 96% returning to housework
to 36% returning to kneeling. The Wilcoxon signed-rank test was used to compare the
expected time and the actual time to return: Housework (Z=−5.631, P<.05, effect size=0.64) and swimming (Z=−3.209, P<.05, effect size=0.59) were quicker than expected, and walking >1 km (Z=−2.324, P<.05, effect size=0.27) was slower than expected.
Conclusions
A more tailored and personalized approach with consideration of prior level of activity
and comorbidities must be taken into account and adequately discussed to help bridge
the gap between the expected and actual recovery time.
Keywords
List of abbreviations:
EQ-5D (EuroQol-5D), KA (knee arthroplasty), KOOS (knee injury and osteoarthritis outcome score), OA (osteoarthritis), OKS (Oxford Knee Score), RA (rheumatoid arthritis), TKA (total knee arthroplasty), UKA (unicompartmental knee arthroplasty), VAL (valued activities list), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 27, 2018
Footnotes
Supported by Oxford University Hospitals charitable fund reference 9822 (Facer Legacy).
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
