Patients who underwent total hip or knee arthroplasty are more physically active than the general Dutch population

Abstract

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) bring relief of pain and functional disability to patients with end-stage osteoarthritis, and however, the literature on their impact on patients’ level of physical activity (PA) is scarce. Cross-sectional study in patients who underwent THA/TKA surgery in the preceding 6–22 months and a random sample of persons aged >40 years from the Dutch general population, participating in a national survey. PA in minutes per week (min/week) and adherence to the Dutch recommendation for PA (NNGB yes/no) were measured by the short questionnaire to assess health-enhancing PA. Multivariable linear (total min/week) and logistic regression analyses (meeting recommendations PA), adjusting for confounders, were performed for THA and TKA separately. In total, 258 THA [62.3% female, aged 69.4 (9.1)] and 221 TKA [65.7% female, aged 69.5 (8.9)] patients and 4373 persons from the Dutch general population [51.4% female, aged 58.9 (11.6)] were included. The presence of THA was associated after adjusting for age, sex, BMI education and musculoskeletal comorbidities, with more total min/week spent on PA (THA 13.8% increase, 95% CI 1.6–27.6%), whilst both TJA groups were associated with adhering to NNGB (THA: OR 1.79, 95% CI 1.26–2.56; TKA: OR 1.73, 95% CI 1.20–2.51). As this study used questionnaires to compare the PA of THA/TKA patients to the general population, some recall and selection bias might have been induced. After surgery, overall, TJA patients are more likely to adhere NNGB than a representative sample of persons >40 years from the Dutch general population.

Comparison of physical activity among different subsets of patients with knee or hip osteoarthritis and the general population

“…This study has an observational cross-sectional design; research questions were answered by secondary analyses of data from four studies performed in the Netherlands in four different populations: (1) patients with knee or hip OA in primary care [26], (2) patients with generalized OA in secondary care [27], (3) patients with knee or hip OA who underwent TJA [23,28], and (4) the general population [29]. Only data of subjects ≥ 50 years were included in this study.…”

“…Moreover, these studies concluded that PA after TJA was less compared to that of healthy controls [20][21][22]. On the other hand, Meessen et al found that patients following TJA were more physically active compared to the general population [23]. In none of the aforementioned studies, the nature of performed activities in different stages of the disease was presented.…”

Does Activity-Based Rehabilitation With Goal Attainment Scaling Increase Physical Activity Among Younger Knee Arthroplasty Patients? Results From the Randomized Controlled ACTION Trial

“…Although the beneficial effects of PA on musculoskeletal and cardiorespiratory health are indisputable [5], it remains doubtful whether patients actually increase their PA following KA [6,7]. Previous studies showed significant improvements in patientreported function and self-reported PA after KA [8,9]. Unfortunately, it is known that people in general [10], and KA patients in particular tend to overestimate their daily PA [9,11].…”

Trajectory of physical activity following total hip and knee arthroplasty: data from the English Longitudinal Study of Ageing (ELSA) cohort

“…Previous quantitative analyses have provided variable and inconsistent conclusions on physical activity after THA and TKA [21][22][23][24][25][26][27][28]. However, the current evidence-base has focused on assessing changing participatory levels of sports and exercise, rather than lower levels of physical activity pursuits which may be more typical of the majority of the arthroplasty population [12].…”

“…However this has been limited through potential recall bias, being largely collected retrospectively or through telephone interviews [26]. Furthermore, changes in physical activity have previously only been assessed over two time-points i.e.…”