Assessment of functional recovery after total hip and knee arthroplasty: An observational study of 95 patients

Mark-Christensen, Troels; Kehlet, Henrik

doi:10.1002/msc.1409

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…In addition, pain catastrophizing has been found to influence pain intensity via muscle weakness and disability ( Tanaka, Hirohama & Ozawa, 2019 ), and our results showed that those with high PCS had increased pain, muscle weakness, and disability, suggesting this relationship. In line with these results, Somers et al (2009) also found that pain catastrophizing affected walking speed in participants with OA, and Mark-Christensen & Kehlet (2019) observed that participants with poorer physical performance had significantly greater levels of pain catastrophizing.…”

Section: Discussionsupporting

confidence: 55%

“…On the other hand, Riddle et al (2010) found that PCS might not be a predictor of function outcome. Along these lines, Mark-Christensen & Kehlet (2019) observed that participants with low physical functioning who were scheduled for a total KA had slightly higher levels of PCS both preoperatively and 4 months postoperatively. However, no significant differences were observed between the groups, and no strong correlations were observed between preoperative PCS and function.…”

Section: Discussionmentioning

confidence: 91%

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Assessment of postoperative health functioning after knee arthroplasty in relation to pain catastrophizing: a 6-month follow-up cohort study

Terradas-Monllor

Ochandorena-Acha

Salinas-Chesa³

et al. 2020

PeerJ

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Background Knee arthroplasty (KA) is a typically successful surgical procedure commonly performed to alleviate painin participants with end-stage knee osteoarthritis. Despite its beneficial effects, a significant proportion of individuals with KA continue experiencing persistent pain and functional limitations. The purpose of this study was to assess the postoperative outcomes after KA in relation to postoperative pain catastrophizing. Methods Participants were recruited at a domiciliary physiotherapy service, using a prospective, observational, hypothesis-generating cohort design. Participants were divided into two groups based on their Pain Catastrophizing Scale (PCS) total score (50th percentile), which resulted in high and low PCS groups. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, quality of life, walking speed, physical performance, range of motion, and pain were measured. Outcome measures were collected at baseline (1 week postoperatively) and at follow-up (1, 3, and 6 months postoperatively). Results A total of 60 participants (21 total KA and 39 unicompartmental KA) were recruited. Individuals with a higher degree of pain catastrophizing showed significantly higher WOMAC total scores at every follow-up, indicating poorer health functioning (p < 0.01). Similarly, the high PCS group showed higher WOMAC pain, stiffness and disability subscale scores (p < 0.05), poorer quality of life (p < 0.01), and poorer physical performance (p < 0.05) at every follow-up. In addition, the high PCS group achieved a slower walking speed at baseline and at 3 months follow-up (p < 0.05), and a higher degree of pain at rest, on walking and on knee flexion at every follow-up (p < 0.01, p < 0.05 and p < 0.05, respectively) except for walking pain at 3 months follow-up. No significant differences were observed between groups in range of motion, except for active knee extension at the 6-month follow-up (p < 0.05). Effect size was large at 1 month follow-up in WOMAC total score (r = 0.578) and pain intensity during knee flexion (r = 0.529). Longitudinal analyses revealed different improvement trends during the rehabilitation process between groups, with a lack of significant improvements in the high PCS group between the 3- and 6-month follow-up in WOMAC total score, WOMAC pain, WOMAC disability, quality of life, physical performance, active knee extension and resting pain (p > 0.05). Conclusion The results of the present study suggest that participants with high postoperative pain catastrophizing might have poorer outcomes during the rehabilitation process after KA. Future work should seek to clarify if this relationship is causal.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 91%

Assessment of postoperative health functioning after knee arthroplasty in relation to pain catastrophizing: a 6-month follow-up cohort study

Terradas-Monllor

Ochandorena-Acha

Salinas-Chesa³

et al. 2020

PeerJ

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“…The relationship between PROMs and PBTs has been investigated and discussed in literature before. Especially in the early postoperative period, weak correlations have been described between HOOS scores and PBTs, such as TUG, Stair-Climbing test and 30CST [ 12 , 21 ] Due to the discrepancy between these two methods, the combined use of both methods is recommended during the early clinical stages to avoid overestimation of patient functional capacity [ 7 , 11 ]. In our study, however, moderate correlations between HOOS scores and TUG and even strong correlations between some subscales of HOOS and 30CST were found in THA patients 12 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Self-Reported Function, Functional Tests and Biomechanical Parameters in Patients 12 Months After Total Hip Arthroplasty: A Preliminary Cross-Sectional Study

John

Esch

Steinert

et al. 2023

JOIO

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Background/Purpose Several methods are used to evaluate the outcome of total hip arthroplasty (THA), however, their relationship at different time points after surgery is unclear. The purpose of this exploratory study was to investigate correlations between self-report function, performance-based tests (PBTs) and biomechanical parameters in patients 12 months after THA. Methods Eleven patients were included in this preliminary cross-sectional study. Hip disability and Osteoarthritis Outcome Score (HOOS) was completed for self-reported function. As PBTs, the Timed-up-and-Go test (TUG) and 30-Second-Chair-Stand test (30CST) were used. Biomechanical parameters were derived from analyses of hip strength, gait and balance. Potential correlations were calculated using Spearman correlation coefficient r. Results HOOS scores and parameters of PBTs showed moderate to strong correlations (0.3 < r < 0.7). Correlation analysis between HOOS scores and biomechanical parameters revealed moderate to strong correlations for hip strength whereas correlations with gait parameters and balance were rather weak (r < 0.3). Moderate to strong correlations were also found between parameters of hip strength and 30CST. Conclusion For THA outcome assessment 12 months after surgery, our first results indicate that self-report measures or PBTs could be used. Analysis of hip strength also appears to be reflected in HOOS and PBT parameters and may be considered as an adjunct. Given the weak correlations with gait and balance parameters, we suggest that gait analysis and balance testing should be performed in addition to PROMs and PBTs as they may provide supplementary information, especially for THA patients that are at risk for falls.

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“…Within the first 3-weeks after THA or TKA patients report improved PF (HOOS & KOOS), but this was not correlated with objectively assessed PF (paced-walk, chairstand, stair-climb tests) (12). Also, at 4-months followup self-reported PF (HOOS & KOOS) improved significantly whereas performance-based function (30-second chair stand-test) improved only slightly (13). HOOS scores one year after THA were not in line with objectively measured improvements in performance-based function and gait (14).…”

Section: Introductionmentioning

confidence: 92%

Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA

Jelsma¹,

Kuijk²,

Buil³

et al. 2021

Acta Orthop Belg

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In orthopaedics, patient reported outcomes (PROMs) are designed to quantify changes in pain and to assess physical function, most often after joint arthroplasty. However, PROMs have some disadvantages, most important is their subjective nature. The aim was to investigate how patient-self-reported-outcomes of general health, disease-specific outcome and physical function, joint-awareness and self-perceived activity- levels are correlated with objectively-measured physical-activity (PA) parameters derived from wearable activity-monitors (AM) in subjects with a hip-arthroplasty. A prospective cohort study was conducted in a group of 32 patients, with a mean follow-up of 10 years after total hip arthroplasty. To assess different domains, the SF-36 (general health), HOOS-PS (pain/functional outcome), FJS-12 (joint awareness) and SQUASH (physical activity) were chosen. Activity-monitoring was performed using a 3-axis accelerometer, gyroscope and magnetometer. No significant correlations between PA-parameters and the FJS-12 and SQUASH were found. The HOOS- PS was significant correlated with BMI, the daily time walking and total-time active and the amount of daily steps. The physical functioning-subscale of the SF-36 was significant negative correlated with BMI and time sitting, but significant positive correlated with time walking, total-time active and the amount of daily steps. Considering the value of PA for maintaining general health, the value of using sensor-based AMs to assess efficacy of treatments in this health related dimension or use it as a tool for patient education, awareness and communication, seems very high.

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Assessment of functional recovery after total hip and knee arthroplasty: An observational study of 95 patients

Cited by 5 publications

References 34 publications

Assessment of postoperative health functioning after knee arthroplasty in relation to pain catastrophizing: a 6-month follow-up cohort study

Assessment of postoperative health functioning after knee arthroplasty in relation to pain catastrophizing: a 6-month follow-up cohort study

Relationship Between Self-Reported Function, Functional Tests and Biomechanical Parameters in Patients 12 Months After Total Hip Arthroplasty: A Preliminary Cross-Sectional Study

Only limited correlations between patient-reported outcomes and objectively monitored physical activity 10-years after THA

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