Preoperative physical factors that predict stair-climbing ability at one month after total knee arthroplasty

Abstract

The aim of this study was to find out which physical performance factors in patients before a knee replacement operation (total knee arthroscopy) can be used to predict what the patient's stair-climbing ability might be at one month after the operation. Patients having a primary total knee arthroplasty in one knee were enrolled in a prospective cohort study (a study that follows a group of similar patients over time, who differ in terms of a number of factors). The results show that scores on the following tests before the operation were the best independent predictors of the time taken to climb the stairs after the operation. These were: Timed Up-and-Go test scores and extensor torque of the operated knee. The time taken to descend the stairs after the operation were strongly predicted by the time taken to descend stairs before the operation and the patient's age. These findings will be useful in developing pre-and post-operative rehabilitation strategies for improving stair-climbing ability in the early stages after total knee arthroplasty. Objective: To identify preoperative physical performance factors that predict stair-climbing ability at one month after total knee arthroplasty. Design: Prospective cohort study. Setting: University-based rehabilitation centre. Subjects: Eighty-four patients who underwent a primary unilateral total knee arthroplasty. Methods: Before and one month post-operation, the patients completed physical performance tests, including a stair-climbing test, a 6-minute walk test, a Timed Up-and-Go test, tests of the isometric flexor and extensor strength of the operated and nonoperated knees, and instrumental gait analysis. Disease-specific physical function was measured by the Western Ontario McMaster Universities Osteoarthritis Index. Results: Correlation analysis showed that postoperative stair-climbing test scores were significantly correlated with preoperative physical performance and function. Linear regression analysis showed that postoperative stair-ascent scores were correlated with preoperative Timed Up-and-Go test scores and peak torque of the extensor of the operated knee. Postoperative stair-descent scores were positively correlated with preoperative stair-descent scores and age. Conclusion: The results show that preoperative balance ability and quadriceps strength in the operated knee could influence postoperative stair-climbing ability at one month after total knee arthroplasty. These findings will be useful for developing pre-and post-operative rehabilitation strategies for improving stair-climbing ability in the early stages after total knee arthroplasty.

Outcomes of Patellar Replacement Vs Patellar Neurectomy in Total Knee Replacement

“…Group B participants showed excellent Results. NRS score decreased to 0 in Group B (14) . While in patellar Neurectomy group A two patients experienced still moderate pain, remaining 13 patients although did not experienced pain but felt numbness on limbs, which also effected their lives.…”

“…Advanced destructive osteoarthritis of the patellofemoral joint (PFJ) results in AKP symptoms (14) . A problem without patellar resurfacing TKA is chondrolysis of the patella.…”

What can we expect from patellar denervation in knee arthroplasty? An updated systematic review and meta-analysis

“…This may also be explained by the fact that knee strength or knee function is influenced by many factors other than pain. 42–45…”

Prevalence of Sarcopenia and Sarcopenic Obesity in an Academic Total Joint Arthroplasty Practice

“…Some have advocated for a definition using multiple parameters, such as low muscle strength, low muscle quantity or quality, and low physical performance [ 21 ]. Muscle performance assessment has emerged in recent years as a surrogate measure correlating with postoperative function, though there is not yet consensus regarding the optimal method [ [55] , [56] , [57] , [58] ]. Tests of gait speed or lower extremity mechanics may be indicative of poor global muscle function; however, these can be confounded by arthritis-associated pain and dysfunction of the lower extremities or mobility.…”