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

Cherian, Jeffrey J.; O’Connor, Mary I.; Robinson, Kristin; Jauregui, Julio J.; Adleberg, Jason; Mont, Michael A.

doi:10.1016/j.arth.2015.03.032

Cited by 35 publications

(42 citation statements)

References 22 publications

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“…14,15,17,18,48,49 In one study, women demonstrated greater improvement than men on Western Ontario and McMaster Universities Arthritis Index (WOMAC) function and pain scores after TKA. 48 Meanwhile, several studies have shown that women score lower and improve less on the Knee Society Score (KSS) after TKA, 14,16,18,50 while other investigations have indicated no sex differences in KSS. 15,18,48 While many more studies have focused on subjective outcomes after TKA, far fewer have focused on performance measures of muscle and physical function that were utilized in the present analysis.…”

Section: Discussionmentioning

confidence: 99%

Men and Women Demonstrate Differences in Early Functional Recovery After Total Knee Arthroplasty

Gustavson¹,

Wolfe²,

Eckhoff

et al. 2016

Archives of Physical Medicine and Rehabilitation

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Objective To investigate whether sex impacts the trajectory of functional recovery following total knee arthroplasty (TKA). Design Retrospective analysis from a historical database containing data from three prospective clinical trials and a pilot study. Setting All studies were performed in a clinical laboratory setting. Participants Recruitment across studies was restricted to patients who underwent an elective unilateral TKA for the treatment of osteoarthritis and were between 50–85 years of age (N=301). Intervention Across all four studies patients received a TKA and physical therapy intervention. Measures of physical function and strength were assessed prior to TKA, 1, 3, and 6 months after TKA. Main Outcome Measures Statistical inference using a maximum likelihood model for repeated measures was done to estimate the changes in outcomes by sex from pre-surgical assessment compared to 1, 3, and 6 months after TKA. Muscle strength was assessed during maximal isometric quadriceps and hamstrings contractions. Muscle activation was assessed in the quadriceps muscle. Physical function outcomes included: Timed-Up-and-Go (TUG), Stair Climbing Test (SCT), and the Six-Minute Walk Test (6MWT). Results Women demonstrated less decline in quadriceps strength than men at 1, 3, and 6 months after TKA (p<0.04), whereas women demonstrated less decline in hamstrings strength 1 month after TKA (p<0.0001). Women demonstrated a greater decline than men on the TUG (p=0.001), SCT (p=0.004), and 6MWT (p=0.001) 1 month after TKA. Sex differences in physical function did not persist at 3 and 6 months following TKA. Conclusions Sex impacted early recovery of muscle and physical function within the first month after TKA. Women demonstrated better preservation of quadriceps strength, but demonstrated greater decline on measures of physical function compared to men.

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Section: Discussionmentioning

confidence: 99%

Men and Women Demonstrate Differences in Early Functional Recovery After Total Knee Arthroplasty

Gustavson¹,

Wolfe²,

Eckhoff

et al. 2016

Archives of Physical Medicine and Rehabilitation

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“…Finally, the primary outcome treatment effect was estimated using a per‐protocol approach. Given the differences in sex in TKR outcomes , exploratory analysis was undertaken to investigate and compare the intervention effect by sex using interaction terms. An additional analysis was conducted to investigate the effect of class size on 12 month LEFS scores using linear regression.…”

Section: Methodsmentioning

confidence: 99%

Effect of Group‐Based Outpatient Physical Therapy on Function After Total Knee Replacement: Results From a Multicenter Randomized Controlled Trial

Lenguerrand

Artz

Marques

et al. 2020

Arthritis Care & Research

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Objective. To evaluate the long-term clinical effectiveness of a novel group-based outpatient physical therapy (PT) following total knee replacement (TKR).Methods. In this 2-center, unblinded, superiority, randomized controlled trial, 180 patients on a waiting list for primary TKR due to osteoarthritis were randomized to a 6 session group-based outpatient PT intervention and usual care (n = 89) or usual care alone (n = 91). The primary outcome was patient-reported functional ability measured by the Lower Extremity Functional Scale at 12 months postoperative. Secondary outcomes included knee symptoms, depression, anxiety, and satisfaction. Questionnaires were completed preoperatively and at 3, 6, and 12 months postoperatively.Results. The mean difference in function between groups was 4.47 (95% confidence interval [95% CI] 0.20, 8.75; P = 0.04) at 12 months postoperative, favoring the intervention. The mean difference in function between groups decreased over time, from 8.1 points at 3 months (95% CI 3.8, 12.4; P < 0.001) to 5.4 (95% CI 1.1, 9.8; P = 0.015) at 6 months postoperative. There were no clinically relevant differences in any secondary outcomes between groups, although patients in the intervention group were more likely to be satisfied with their PT. No serious adverse events related to the intervention were reported.Conclusion. Supplementing usual care with this group-based outpatient PT intervention led to improvements in function at 12 months after TKR, although the magnitude of the difference was below the minimum clinically important difference of 9 points. However, patient satisfaction was higher in the intervention group, and there was some evidence of clinically relevant improvements in function at 3 months.

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“…[24] In terms of total knee arthroplasty, several studies reported that functional outcomes were different between men and women. [25][26][27] On the contrary, another study suggested that gender does not seem to affect clinical outcome. [28] However, no study has been conducted examining the outcomes of gender-based differences in TAA.…”

Section: Introductionmentioning

confidence: 98%

mentioning

confidence: 99%

“…36 scores of the hip and knee [23,25]. Cherian et al analyzed 272 consecutive total knee arthroplasty and reported that the SF-36 PCS was significantly better in men at 7 years of follow-up [25]. Khashan et al suggested that gender-related analysis resulted in significantly higher scores for men compared to women in SF-36 scores for hip osteoarthritis patients [23].…”

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confidence: 99%

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Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?

Lee

2020

Preprint

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Background Total ankle arthroplasty has progressed as a treatment option for patients with ankle osteoarthritis. However, no studies have been conducted to evaluate the effect of gender on the outcome. The purpose of the present study was to evaluate outcomes, survivorship, and complications rates of total ankle arthroplasty, according to gender differences. Methods This study included 187 patients (195 ankles) that underwent mobile-bearing HINTEGRA prosthesis at a mean follow-up of 7.5 years (range, 4 to 14). The two groups consisted of a men’s group (106 patients, 109 ankles) and a women’s group (81 patients, 86 ankles). Average age was 64.4 years (range, 45 to 83). Results Clinical scores on the Ankle Osteoarthritis Scale for pain and disability, and American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved and were not significantly different between the two groups at the final follow-up. There were no significant differences in complication rates and implant survivorship between the two groups. The overall survival rate was 96.4% in men and 93.4% in women at a mean follow-up of 7.5 years (p=0.621). Conclusions Clinical outcomes, complication rates, and survivorship of total ankle arthroplasty were comparable between men and women. These results suggest that gender did not seem affect outcomes of total ankle arthroplasty in patients with ankle osteoarthritis.

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

Cited by 35 publications

References 22 publications

Men and Women Demonstrate Differences in Early Functional Recovery After Total Knee Arthroplasty

Men and Women Demonstrate Differences in Early Functional Recovery After Total Knee Arthroplasty

Effect of Group‐Based Outpatient Physical Therapy on Function After Total Knee Replacement: Results From a Multicenter Randomized Controlled Trial

Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?

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