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Qu W, Yan Z, Wei H, Zhang S, Wang X, Liu M, Wang J, Luan X. Heterogeneity of social participation in patients three months after total knee arthroplasty: a latent profile analysis. BMC Musculoskelet Disord 2024; 25:619. [PMID: 39090646 PMCID: PMC11295653 DOI: 10.1186/s12891-024-07744-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Social participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients' functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients. METHODS This cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants' data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients' social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups. RESULTS Three months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05). CONCLUSION These results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.
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Affiliation(s)
- Wenran Qu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China
| | - Zeping Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China
- University of Health and Rehabilitation Sciences, No. 17, Shandong Road, Shinan district, Qingdao City, Shandong Province, China
| | - Huimin Wei
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China
| | - Simeng Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China
| | - Xiaoli Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China
| | - Mengqi Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China
| | - Jiurui Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China
| | - Xiaorong Luan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China.
- Department of Infection Control, Qilu Hospital of Shandong University, Room 408, Youth Building, No. 107, West Culture Road, Lixia District, Jinan City, 250014, Shandong Province, China.
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Birkenes T, Furnes O, Lygre SHL, Solheim E, Årøen A, Knutsen G, Drogset JO, Heir S, Engebretsen L, Løken S, Visnes H. Previous cartilage surgery is associated with inferior patient-reported outcomes after knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2024; 32:361-370. [PMID: 38294966 DOI: 10.1002/ksa.12050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The hypothesis of the present study assumed that a history of focal cartilage lesions would not affect Knee Injury and Osteoarthritis Outcome scores (KOOSs) following knee arthroplasty compared to a matched national cohort of knee arthroplasty patients. METHODS Fifty-eight knee arthroplasty patients with previous surgery for focal cartilage lesions (cartilage cohort) were compared to a matched cohort of 116 knee arthroplasty patients from the Norwegian Arthroplasty Register (control group). Age, sex, primary or revision arthroplasty, type of arthroplasty (total, unicondylar or patellofemoral), year of arthroplasty surgery and arthroplasty brand were used as matching criteria. Demographic data and KOOS were obtained through questionnaires. Regression models were employed to adjust for confounding factors. RESULTS Mean follow-up post knee arthroplasty surgery was 7.6 years (range 1.2-20.3) in the cartilage cohort and 8.1 (range 1.0-20.9) in the control group. The responding patients were at the time of surgery 54.3 versus 59.0 years in the cartilage and control group, respectively. At follow-up the control group demonstrated higher adjusted Knee Injury and Osteoarthritis Outcome subscores than the previous focal cartilage patients with a mean adjusted difference (95% confidence interval in parentheses): Symptoms 8.4 (0.3, 16.4), Pain 11.8 (2.2, 21.4), Activities of daily living (ADL) 9.3 (-1.2, 18.6), Sport and recreation 8.9 (-1.6, 19.4) and Quality of Life (QoL) 10.6 (0.2, 21.1). The control group also demonstrated higher odds of reaching the patient-acceptable symptom state threshold for the Knee Injury and Osteoarthritis Outcome subscores with odds ratio: Symptoms 2.7 (1.2, 6.4), Pain 3.0 (1.3, 7.0), ADL 2.1 (0.9, 4.6) and QoL 2.4 (1.0, 5.5). CONCLUSION Previous cartilage surgery was associated with inferior patient-reported outcomes after knee arthroplasty. These patients also exhibited significantly lower odds of reaching the patient-acceptable symptom state threshold for the Knee Injury and Osteoarthritis Outcome subscores. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Thomas Birkenes
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
- Sports Traumatology and Arthroscopy Research Group, Bergen, Norway
| | - Ove Furnes
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
- Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Stein Håkon Låstad Lygre
- Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Eirik Solheim
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Asbjørn Årøen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Akershus University Hospital, Lorenskog, Norway
- Oslo Sports Trauma Research Center, Oslo, Norway
| | | | - Jon Olav Drogset
- Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Knee Ligament Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Stig Heir
- Martina Hansen Hospital, Baerum, Norway
| | - Lars Engebretsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Oslo Sports Trauma Research Center, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | | | - Håvard Visnes
- Oslo Sports Trauma Research Center, Oslo, Norway
- Norwegian Knee Ligament Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
- Hospital of Southern Norway, Kristiansand, Norway
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