Is discharge knee range of motion a useful and relevant clinical indicator after total knee replacement? Part 2

Naylor, Justine; Ko, Victoria; Rougellis, Steve; Green, Nick; Mittal, Rajat; Heard, Rob; Yeo, Anthony E. T.; Barnett, Arnold; Hackett, Danella; Saliba, Chris; Smith, Nicole A.; Mackey, Martin; Harmer, Alison R.; Harris, Ian A.; Adie, Sam; McEvoy, Linda

doi:10.1111/j.1365-2753.2011.01656.x

Cited by 29 publications

(35 citation statements)

References 21 publications

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“…The measurements on postoperative day 2 in this study were not related to long-term outcomes. However, in Australian studies 28,29 in which hospital stays are longer, inpatient ROM measurements of extension performed at discharge on postoperative days 6–8 were related to long-term extension ROM; the same relationship was not observed for flexion.…”

Section: Discussionmentioning

confidence: 85%

Predicting Functional Performance and Range of Motion Outcomes After Total Knee Arthroplasty

Bade

Kittelson

Kohrt

et al. 2014

American Journal of Physical Medicine &Amp; Rehabilitation

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Objective The aim of this study was to assess the predictive value of functional performance and range of motion measures on outcomes after total knee arthroplasty. Design This is a secondary analysis of two pooled prospective randomized controlled trials. Sixty-four subjects (32 men and 32 women) with end-stage knee osteoarthritis scheduled to undergo primary total knee arthroplasty were enrolled. Active knee flexion and extension range of motion, Timed Up and Go (TUG) test time, and 6-min walk test distance were assessed. Results Preoperative measures of knee flexion and extension were predictive of long-term flexion (β = 0.44, P < 0.001) and extension (β = 0.46, P < 0.001). Acute measures of knee flexion and extension were not predictive of long-term flexion (β= 0.09, P = 0.26) or extension (β = 0.04, P = 0.76). Preoperative TUG performance was predictive of long-term 6-min walk performance (β = −21, P < 0.001). Acute TUG performance was predictive of long-term functional performance on the 6-min walk test, after adjusting for the effects of sex and age (P = 0.02); however, once adjusted for preoperative TUG performance, acute TUG was no longer related to long-term 6-min walk performance (P = 0.65). Conclusions Acute postoperative measures of knee range of motion are of limited prognostic value, although preoperative measures have some prognostic value. However, acute measures of functional performance are of useful prognostic value, especially when preoperative functional performance data are unavailable.

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Section: Discussionmentioning

confidence: 85%

Predicting Functional Performance and Range of Motion Outcomes After Total Knee Arthroplasty

Bade

Kittelson

Kohrt

et al. 2014

American Journal of Physical Medicine &Amp; Rehabilitation

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“…Nine published studies [10,13-20] reported the change in mean OKS from baseline to 12 months after primary knee replacement surgery for 13 different groups containing 4,369 patients in total (Table 2). Three studies were RCTs and six were prospective cohort studies.…”

Section: Resultsmentioning

confidence: 99%

“…The risk of selection bias in the recruitment of study participants was considered low in four of the hip replacement studies [6,8,11,12] and eight of the knee replacement studies [13-20] as there was clear evidence that consecutive eligible patients were invited to take part. In two of the hip replacement studies [9,10] and one of the knee replacement studies [10] it was unclear whether this was true.…”

Section: Resultsmentioning

confidence: 99%

What is the optimal time point to assess patient-reported recovery after hip and knee replacement? a systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme

Browne

Bastaki

Dawson

2013

Health Qual Life Outcomes

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BackgroundIt is unclear if there is a clinically important improvement in the six to 12-month recovery period after hip and knee replacement. This is an obvious gap in the evidence required by patients undergoing these procedures. It is also an issue for the English PROMs (Patient-Reported Outcome Measures) Programme which uses 6-month outcome data to compare the results of hospitals that perform hip and knee replacements.MethodsA systematic review of studies reporting the Oxford Hip Score (OHS) or Oxford Knee Score (OKS) at 12 months after surgery was performed. This was compared with six-month outcome data collected for 60, 160 patients within the English PROMs programme. A minimally important difference of one standard error of the measurement, equivalent to 2.7 for the OHS and 2.1 for the OKS, was adopted.Results and discussionSix studies reported OHS data for 10 different groups containing 8,308 patients in total. In eight groups the change scores reported were at least 2.7 points higher than the six-month change observed in the PROMs programme (20.2 points). Nine studies reported OKS data for 13 different groups containing 4,369 patients in total. In eight groups the change scores reported were at least 2.1 points higher than the six-month change observed in the PROMs programme (15.0 points).ConclusionsThere is some evidence from this systematic review that clinically important improvement in the Oxford hip and knee scores occurs in the six to 12 month recovery period. This trend is more apparent for hip than knee replacement. Therefore we recommend that the English Department of Health study the impact on hospital comparisons of using 12- rather than six-month outcome data.

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“…Naylor et al found that discharge knee ROM may be a useful clinical indicator to evaluate long-term knee ROM restoration prognosis and it may be important for physiotherapists to maximize knee ROM in the early and sub-acute stages after TKA procedures [7]. Restoration of postoperative knee ROM affects both the patient’s health and medical service expenditures.…”

Section: Introductionmentioning

confidence: 99%

“…Patients who have difficulties in regaining the knee ROM must be discovered early and provided with more health services and direct assistance [8]. Of interest to these studies [5,6,7,8], active knee flexion recovery before hospital discharge has revealed a correlation with knee ROM at 12 months postoperation [7,8]. This would suggest that if patients can improve their knee flexion during the early acute inpatient stage, long-term health outcomes and early discharge will be beneficial to the patients.…”

Section: Introductionmentioning

confidence: 99%

Data Collection and Analysis Using Wearable Sensors for Monitoring Knee Range of Motion after Total Knee Arthroplasty

Chiang¹,

Chen

Liu³

et al. 2017

Sensors

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Total knee arthroplasty (TKA) is the most common treatment for degenerative osteoarthritis of that articulation. However, either in rehabilitation clinics or in hospital wards, the knee range of motion (ROM) can currently only be assessed using a goniometer. In order to provide continuous and objective measurements of knee ROM, we propose the use of wearable inertial sensors to record the knee ROM during the recovery progress. Digitalized and objective data can assist the surgeons to control the recovery status and flexibly adjust rehabilitation programs during the early acute inpatient stage. The more knee flexion ROM regained during the early inpatient period, the better the long-term knee recovery will be and the sooner early discharge can be achieved. The results of this work show that the proposed wearable sensor approach can provide an alternative for continuous monitoring and objective assessment of knee ROM recovery progress for TKA patients compared to the traditional goniometer measurements.

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Is discharge knee range of motion a useful and relevant clinical indicator after total knee replacement? Part 2

Cited by 29 publications

References 21 publications

Predicting Functional Performance and Range of Motion Outcomes After Total Knee Arthroplasty

Predicting Functional Performance and Range of Motion Outcomes After Total Knee Arthroplasty

What is the optimal time point to assess patient-reported recovery after hip and knee replacement? a systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme

Data Collection and Analysis Using Wearable Sensors for Monitoring Knee Range of Motion after Total Knee Arthroplasty

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