Patient activity after TKA depends on patient-specific parameters

[Objectifying results in total knee arthroplasty: Is "patient satisfaction" adequate]

BACKGROUND

Arthroplasty is an effective treatment for end-stage osteoarthritis of the knee and is one of Germany's most frequently performed orthopedic procedures.

DISCUSSION

However, a considerable number of patient are not satisfied with the results after knee arthroplasty. The patient's perspective is particularly important for shared decision making. "Patient satisfaction" with the surgery is an expression of the patient's perspective, but might not be sufficient as the only outcome measure. There is no international consensus which outcome measures should be used after knee arthroplasty.

CONCLUSION

Therefore, different measurement tools are used for the acquisition of a variety of outcome measures in order to quantify the results of knee arthroplasty. These tools should be used according to their reliability, validity, and responsiveness. This article provides an overview about available measurement tools.

Relationship Between Accelerometer-Measured Activity and Self-Reported or Performance-Based Function in Older Adults with Severe Aortic Stenosis

In older adults with aortic stenosis, we evaluated whether accelerometer-measured physical activity provides distinct clinical information apart from self-reported surveys or performance-based function tests. We employed wrist-mounted accelerometry in 52 subjects with severe aortic stenosis prior to transcatheter aortic valve replacement (TAVR). Daily daytime activity was estimated using the maximum 10 h of daily accelerometer-measured activity (M10) reported in activity counts. Subjects completed baseline surveys (New York Heart Association (NYHA), Short Form 12 (SF12), Kansas City Cardiomyopathy Questionnaire (KCCQ), EuroQol-5D (EQ-5D), Revised Life Orientation Test (LOT-R), Life Space, Detailed Activity Form) and performance-based function tests (Short Physical Performance Battery, 6-min walk test distance, grip strength) to estimate functional status. Simple and multiple linear regression models were used to evaluate the relationship between accelerometer-measured activity and survey data and performance-based function tests. Among all baseline surveys and performance-based function tests, the only statistically significant univariable relationships identified were weak, negative associations between M10 and SF-12 Mental Composite Score (R²=0.1970, P=0.04) and between M10 and grip strength (R²=0.1568, P=0.004). Neither multiple linear regression of overall survey data (R²=0.6159, P=0.23) nor performance-based function tests (R²=0.1743, P=0.10) correlated with M10. Self-reported surveys and performance-based function tests are not meaningfully correlated with daytime accelerometer-measured activity. The results of our study suggest that accelerometer-measured physical activity provides distinct clinical information apart from self-reported surveys or performance-based function tests.

A Prospective, Longitudinal Study of Outcomes Following Total Knee Arthroplasty Stratified by Gender

This study aimed to compare temporal trends in outcomes between men and women following TKA. A database of 272 TKAs at 7 years follow-up were evaluated for survivorship, functional, activity, and quality of life outcomes. Evaluation of implant survivorship, KSS scores, and ROM showed no significance differences between men and women, but both functional KSS scores and LEAS showed that men had significantly higher functional scores. The SF-36 physical component was found to be significantly better in men at multiple time points, whereas, the mental component was significantly better in men at pre-operative and 2 years. Both men and women benefit from TKA, however, men have higher levels of function and activity both prior to and after TKA than women.