Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength

Hiyama, Yoshinori; Wada, Osamu; Nakakita, Satoshi; Mizuno, Kiyonori

doi:10.1016/j.otsr.2016.02.007

Cited by 27 publications

(24 citation statements)

References 28 publications

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“…Previous research evaluating recovery trajectories after TKR has established that most improvement in pain and function occurs in the first 3 months post-operative, then further small improvement up to 1 year post-operative, after which outcomes plateau [9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Variability in long-term pain and function trajectories after total knee replacement: A cohort study

Wylde¹,

Penfold²,

Rose³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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Previous research suggests that patient-reported outcomes plateau by one year after total knee replacement (TKR). Analysis of trajectories to date has predominately been based on changes in median/mean scores over the first post-operative year, rather than variability in trajectory patterns over the longer-term. The aim was to evaluate variability in long-term pain and function trajectories after TKR. Hypothesis There will be variability in long-term pain and function trajectories after TKR. Patients and Methods 266 patients undergoing a Triathlon® TKR because of osteoarthritis were recruited from one orthopaedic centre. Participants completed the WOMAC Pain and Function scales preoperatively and then at 3 months, 1 year, 2 years, 3 years, 5 years and 7 years postoperative. Longitudinal analyses evaluated patterns of clinically meaningful change. Results Most patients had an improvement in pain and function during the first year post-operative; improvement was greatest in the first 3 months. By 1 year post-operative, 8% of patients had no change or a worsening of pain and 21% for function. Thereafter, approximately 15% of patients improved and 15% worsened between each assessment time. For those patients who had no change in symptoms from pre-operative to 1 year post-operative, one third had further improvement between one and 2 years post-operative. Discussion This study identified clinically meaningful variability in long-term outcomes after TKR, which could be discussed with patients to ensure they have realistic expectations of their outcome. Further research is needed to evaluate determinants of this variability and whether patients who will do poorly can be identified early in their recovery pathway.

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Section: Introductionmentioning

confidence: 99%

Variability in long-term pain and function trajectories after total knee replacement: A cohort study

Wylde¹,

Penfold²,

Rose³

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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“…The most important finding from the present study is that FJS had a significantly lower ceiling effect and a higher floor effect within the first year after TKA. To the best of our knowledge, only two studies have investigated the use of FJS in the first year after TKA [4,11]. In one of the studies, Hamilton et al successfully validated FJS with OKS and noticed a lower ceiling effect [4], defined as scoring maximum 10% in FJS (12.6% vs. 25.5%).…”

Section: Discussionmentioning

confidence: 99%

“…The rationale behind this was likely that the outcome of surgery had not reached plateau for assessment until 1 year after surgery. Nevertheless, Hiyama et al [11] reported FJS improvement within 6 months after surgery reaching a plateau from 6 to 12 months. Also, with the increasing popularity of fast-track surgery, the need for early outcome assessment has become much greater.…”

Section: Introductionmentioning

confidence: 99%

Forgotten Joint Score for early outcome assessment after total knee arthroplasty: Is it really useful?

Lee,

Chang,

Wong

2020

Knee Surg & Relat Res

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Background: Forgotten Joint Score (FJS) has become a popular tool for total knee arthroplasty (TKA), but almost all studies had assessment performed 1 year after surgery. There is a need for a sensitive tool for earlier outcome assessment. The aim of this study was to investigate the usefulness of FJS within the first year after TKA. Methods: This was a cross-sectional study. Patients within the first year after primary TKA were recruited. FJS was translated into the local language with a cross-cultural adaptation and was validated by assessing the correlation with the Western Ontario and McMaster Universities Arthritis Index score (WOMAC). Ceiling and floor effects (highest or lowest 10% or 15%) of both scores were compared. Skewness of scores was assessed with a histogram. Results: One hundred sixty-three subjects were recruited: 84 (51.5%) had evaluation at 3 months after the operation, 56 (34.4%) at 6 months, and 23 (14.1%) at 12 months. FJS had fewer patients at the highest 10% (10.7% vs. 16.1%, P = 0.046) or 15% (19.6% vs. 32.1%, P = 0.027) at 6 months and within the first year overall (6.7% vs. 13.5%, P <0.001; 14.1% vs. 22.7%, P <0.001). Also, it had more patients at the lowest 10% (16.7% vs. 0%, P <0.001) or 15% (21.4% vs. 0%, P < 0.001) at 3 months, 6 months (10.7% vs. 0%, P <0.001), and overall (12.9% vs. 0%, P <0.001; 16.6% vs. 0%, P <0.001). The skewness was much less than WOMAC (0.09 vs. −0.56). Conclusions: FJS has a low ceiling effect but a high floor effect in the first year after TKA. Such characteristics make it less useful for the general assessment of early patient report outcome after operation.

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“…Another study found that when using the FJS scoring system to evaluate the difference in knee awareness of patients who underwent patellofemoral arthroplasty, unicompartmental knee arthroplasty, and TKA, they found that patients who underwent different joint arthroplasties had large differences in the FJS [13]. Hiyama et al found that quadriceps strength and pain were the main factors affecting joint awareness after TKA [26]. Quadriceps weakness is the main obstacle to patients' functional recovery after TKA, and pain is usually one of the main criteria for success or failure after TKA.…”

Section: Discussionmentioning

confidence: 99%

Mini-midvastus versus medial parapatellar approach in total knee arthroplasty: difference in patient-reported outcomes measured with the Forgotten Joint Score

et al. 2020

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Background: Low knee awareness after minimally invasive total knee arthroplasty (TKA) has become the ultimate target of a natural-feeling knee that meets patient expectations. The objective of this research was to compare the clinical outcomes of TKA via the mini-midvastus (MMV) approach or the medial parapatellar (MPP) approach, and to evaluate which approach can lead to a better quality of life after surgery. Methods: From January 2015 to December 2016, a retrospective cohort study was conducted in 330 patients who underwent TKA via a mini-midvastus (MMV) approach. During this period, we also selected 330 patients who underwent TKA via a medial parapatellar (MPP) approach (MPP group) for comparison. Clinical results were assessed with the visual analog scale score for pain, range of motion, and the Knee Society Score. The Forgotten Joint Score was used to analyze the ability to forget the joint. Results: There were significant differences with regard to visual analog scale score, range of motion, and the Knee Society Score until 6 months after surgery between the MMV and MPP groups (p < 0.05), but the differences were not significant at 12 months, 24 months, and 36 months after surgery. However, there were significant differences in the Forgotten Joint Score between the groups during the follow-up period (p < 0.05). Conclusion: When forgetting the artificial joint after TKA is the ultimate target, better quality of life can be acquired by performing TKA via the MMV approach. In addition, compared with the MPP approach, the MMV approach can offer less pain and a faster recovery.

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Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength

Abstract: Prospective cohort study, IV.

Cited by 27 publications

References 28 publications

Variability in long-term pain and function trajectories after total knee replacement: A cohort study

Variability in long-term pain and function trajectories after total knee replacement: A cohort study

Forgotten Joint Score for early outcome assessment after total knee arthroplasty: Is it really useful?

Mini-midvastus versus medial parapatellar approach in total knee arthroplasty: difference in patient-reported outcomes measured with the Forgotten Joint Score

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