(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.
Prospective longitudinal cohort observational survey.
Specialist orthopedic hospital.
Patients (N=99) with osteoarthritis or rheumatoid arthritis (mean=69.9y [range 44-88]) listed for total knee arthroplasty (TKA) or unicompartmental knee arthroplasty.
Main Outcome Measure
Valued activities list (VAL) used to select activities patients expect to return to and report the actual time taken to return.
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.
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.
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)
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Supported by Oxford University Hospitals charitable fund reference 9822 (Facer Legacy).
© 2018 by the American Congress of Rehabilitation Medicine