Effect of knee arthroplasty on sports participation and activity levels: a systematic review and meta-analysis

Konings, Marco J.; Vroey, Henri De; Weygers, Ive; Claeys, Kurt

doi:10.1136/bmjsem-2019-000729

Cited by 12 publications

(16 citation statements)

References 64 publications

(48 reference statements)

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“…An mounting amount of evidence, including the review by Konings and colleagues, 5 suggests that knee arthroplasty provides a window of opportunity to improve physical activity. As the number of 'younger' knee arthroplasty patients will likely rise in coming years, this opportunity should be taken to provide better participation-based care.…”

Section: Discussionmentioning

confidence: 99%

“…These guidelines can, among others, be based on evidence provided by Konings and colleagues. 5 Unfortunately, evidence in this review was based on self-reports of physical activity and sports, while more information from device-based measurements of those activities is needed.…”

Section: The Importance Of Physical Activity and Other Forms Of Societal Participationmentioning

confidence: 99%

“…In particular for these 'younger' patients, societal participation including activities of daily life, sport and work is essential. 4 Knee arThroplasTy may improve physiCal aCTiviTy and sporTs parTiCipaTion In BMJ Open Sport & Exercise Medicine, Konings and colleagues 5 reported on a systematic review on 19 studies (n=4074 participants) on physical activity and sports participation before and after knee arthroplasty. The authors found that knee arthroplasty, in general, has positive effects on physical activity and sports participation.…”

mentioning

confidence: 99%

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Knee arthroplasty: a window of opportunity to improve physical activity in daily life, sports and work

Coenen

Straat

Kuijer

2020

BMJ Open Sport Exerc Med

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Section: Discussionmentioning

confidence: 99%

Section: The Importance Of Physical Activity and Other Forms Of Societal Participationmentioning

confidence: 99%

mentioning

confidence: 99%

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Knee arthroplasty: a window of opportunity to improve physical activity in daily life, sports and work

Coenen

Straat

Kuijer

2020

BMJ Open Sport Exerc Med

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“…Studies with higher quality evidence have focused on patient-reported outcome measures (PROMs) and other outcomes. In their 2020 meta-analysis of RTS after knee arthroplasty, Konings et al 31 reported the level of participation with several postoperative sporting activities and a greater focus on TKA than UKA. 31 Belsey et al 4 compared RTS after UKA and high-tibial osteotomy (HTO) in their meta-analysis, with a singular focus on PROMs and the ability to return to physical activity between these 2 groups.…”

mentioning

confidence: 99%

“…In their 2020 meta-analysis of RTS after knee arthroplasty, Konings et al 31 reported the level of participation with several postoperative sporting activities and a greater focus on TKA than UKA. 31 Belsey et al 4 compared RTS after UKA and high-tibial osteotomy (HTO) in their meta-analysis, with a singular focus on PROMs and the ability to return to physical activity between these 2 groups. The only similar high-quality study to date is by Witjes et al, 52 who performed a meta-analysis in 2016 comparing RTS in both TKA and UKA but with a greater focus on PROMs.…”

mentioning

confidence: 99%

Return to Sport After Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-analysis

Radhakrishnan

Magan

Kayani

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Patients undergoing unicompartmental knee arthroplasty (UKA) often want to return to sport (RTS) after surgery. However, the time taken to RTS and proportion of patients who RTS after UKA remain unknown. Purpose: To determine the time to RTS and proportion of patients who RTS after UKA. Study Design: Systematic review; Level of evidence, 4. Methods: A search was performed using PubMed, Medline, Embase, SPORTDiscus and the Cochrane Library databases for clinical trials reporting on RTS after UKA published between database inception and September 2021. In addition, a manual search was performed of relevant sports medicine and orthopaedic journals, and bibliographies were reviewed for eligible trials. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to undertake this study. Results: This meta-analysis included 11 studies (749 patients) that reported on RTS after UKA. The proportion of patients returning to sports increased over time: 6 studies (432 patients) demonstrated an overall pooled proportion of 48.1% (95% CI, 36.3%-60.2%) of patients who returned to sport at 3 months after surgery, while 7 studies (443 patients) demonstrated an overall pooled proportion of 76.5% (95% CI, 63.9%-87.1%) of patients who returned to sport at 6 months after surgery. Overall, 92.7% (95% CI, 85.8%-97.4%) of 749 patients were able to RTS at 4 years after surgery. Overall excellent patient-reported functional outcomes scores and low risk of complications with RTS after UKA were reported. Conclusion: The authors found that 48.1% of patients were able to RTS at 3 months after surgery and 76.5% were able to RTS at 6 months after UKA. Pooled proportion analysis showed that >90% of patients undergoing UKA were able to RTS at 48 months after surgery. The majority of patients who were able to RTS after UKA did so at a lower level of intensity than their preoperative level. RTS after UKA was associated with good patient-reported functional outcomes scores and a low risk of complications.

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Total knee arthroplasty improves sports activity and the patient-reported functional outcome at mid-term follow-up

Meena

Hoser

Abermann

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to assess (1) sports participation and preference for the type of sports activity after TKA, (2) mid-term functional outcome and activity level, (3) correlation of different age groups with activity level and functional outcomes, and (4) mid-term survivorship of the prosthesis. Methods A retrospective review of prospectively collected data was performed. 182 patients were included who underwent primary TKA between January 2010 and December 2016. Inclusion criteria were symptomatic knee osteoarthritis, age 50–90 years, and with a minimum of 5-year follow-up after TKA. Patients with rheumatoid arthritis and revision TKA were excluded. Sports participation and sports preference, Oxford Knee Score (OKS), Tegner Activity Level, and Visual Analogue Scale (VAS) for pain were recorded pre- and postoperatively at 6 months, 1 year, 2 years, and 5 years. The patient cohort was subdivided according to age groups; activity levels, patient-reported outcomes, and improvement in knee pain were correlated with these age groups. Kaplan–Meier curves were used to investigate survivorship at a minimum of 5 years. Results The mean age of the cohort was 75.6 ± 7.2 years (range 52–89). Significant improvement was noted in sports participation (p < 0.003). After TKA, there was no change in the preference for sports and none of the patients had to discontinue their sporting activity. OKS improved significantly at all follow-up time points compared to the preoperative score (p < .0001). Patients' sports and physical activity improved significantly at 1 year compared to the preoperative activity level (p < 0.001). Although the Tegner activity level improved over time, this improvement was not significant (NS), while it was significantly higher in males than in females (p < 0.004). Significant improvement was found in the VAS for pain at all follow-up time points compared to the preoperative score (p < .0001). Survivorship was found to be 100% at a 5-year follow-up. Conclusion After TKA, patients can be able to return to sporting activity or even perform better than before surgery. Maximum improvement was noted in the first post-operative year. The male and younger groups perform better than the female and older groups. Sports and physical activity do not negatively impact survivorship of the knee prosthesis at mid-term follow-up and all patients are encouraged to take up sports participation after their TKA. Level of evidence Level 3.

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Effect of knee arthroplasty on sports participation and activity levels: a systematic review and meta-analysis

Cited by 12 publications

References 64 publications

Knee arthroplasty: a window of opportunity to improve physical activity in daily life, sports and work

Knee arthroplasty: a window of opportunity to improve physical activity in daily life, sports and work

Return to Sport After Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-analysis

Total knee arthroplasty improves sports activity and the patient-reported functional outcome at mid-term follow-up

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