The trajectory of recovery and the inter-relationships of symptoms, activity and participation in the first year following total hip and knee replacement

Davis, Aileen M.; Perruccio, Anthony V.; Ibrahim, Selahadin; Hogg‐Johnson, Sheilah; Wong, Raymond M.H.; Streiner, David L.; Beaton, Dorcas; Côté, Pierre; Gignac, Monique A. M.; Flannery, John; Schemitsch, Emil H.; Mahomed, Nizar N.; Badley, Elizabeth M.

doi:10.1016/j.joca.2011.08.007

Cited by 86 publications

(90 citation statements)

References 40 publications

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“…Our results are consistent with the existing literature. 48,341,342,[345][346][347][348][349][350] Improvements in WOMAC physical function beyond 3 months were observed by Bachmeier and colleagues 48 in patients who had undergone hip replacement. However, changes in WOMAC pain were marginal.…”

Section: Discussionmentioning

confidence: 93%

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms PROGRAMME GRANTS FOR APPLIED RESEARCH VOLUME 4 ISSUE 12 AUGUST 2016 ISSN 2050 DOI 10.3310/pgfar04120Improving patients' experience and outcome of total joint replacement: the RESTORE programme Ashley W Blom, Neil Artz, Andrew D Beswick, Amanda Burston, Paul Dieppe, Karen T Elvers, Rachael Gooberman-Hill, Jeremy Horwood, Paul Jepson, Emma Johnson, Erik Lenguerrand, Elsa Marques, Sian Noble, Mark Pyke, Catherine Sackley, Gina Sands, Adrian Sayers, Victoria Wells and Vikki Wylde Improving patients' experience and outcome of total joint replacement: the RESTORE programme ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10070. The contractual start date was in December 2008. The final report began editorial review in September 2014 and was accepted for publication in August 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accurac...

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Section: Discussionmentioning

confidence: 93%

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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“…For our study, we included subjects who had at least 1 TKR since study enrollment with a recorded dale of surgery, who also had physical function data obtained at the study visit prior to TKR and a study visit at least 6 months following TKR, lo allow for Sufficient Surgical recovery lime 10 . Less than 3% of subjects had unicompartmental knee replacement and the rest had TKR; thus we use the term TKR lo describe our sample.…”

Section: Methodsmentioning

confidence: 99%

Does Clinically Important Change in Function After Knee Replacement Guarantee Good Absolute Function? The Multicenter Osteoarthritis Study

et al. 2013

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Objective Poor functional outcomes post knee replacement are common, but estimates of its prevalence vary, likely in part because of differences in methods used to assess function. The agreement between improvement in function and absolute good levels of function after knee replacement has not been evaluated. We evaluated the attainment of improvement in function and absolute good function after total knee replacement (TKR) and the agreement between these measures. Methods Using data from The Multicenter Osteoarthritis (MOST) Study, we determined the prevalence of achieving a minimal clinically important improvement (MCII, ≥ 14.2/68 point improvement) and Patient Acceptable Symptom State (PASS, ≤ 22/68 post-TKR score) on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Function subscale at least 6 months after knee replacement. We also assessed the frequency of co-occurrence of the 2 outcomes, and the prevalence according to pre-knee replacement functional status. Results We included 228 subjects who had a knee replacement during followup (mean age 65 yrs, mean body mass index 33.4,73% female). Seventy-one percent attained the PASS for function after knee replacement, while only 44% attained the MCII. Of the subjects who met the MCII, 93% also attained the PASS; however, of subjects who did not meet the MCII, 54% still achieved a PASS. Baseline functional status was associated with attainment of each MCII and PASS. Conclusion There was only partial overlap between attainment of a good level of function and actually improving by an acceptable amount. Subjects were more likely to attain an acceptable level of function than to achieve a clinically important amount of improvement post knee replacement.

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“…A minimum follow-up time of 6 months was required, as it was theorized that before this time point participants would be unlikely to be adequately rehabilitated. 7 Studies were required to have an objective measure of PA (total or a component of PA), such as accelerometry, pedometry, or direct observation. No restriction was placed on outcome variStudies identified from reference lists of final articles, n = 1…”

Section: Eligibility Criteriamentioning

confidence: 99%

Does Physical Activity Increase After Total Hip or Knee Arthroplasty for Osteoarthritis? A Systematic Review

Arnold¹,

Walters²,

Ferrar³

2016

J Orthop Sports Phys Ther

111

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® T t STUDY DESIGN: Systematic review. T t BACKGROUND: Despite improvements inself-reported symptoms and perceived functional ability after total hip arthroplasty (THA) and total knee arthroplasty (TKA), it is unclear whether changes in objectively measured physical activity (PA) occur after surgery. T t OBJECTIVE:To determine if objectively measured PA increases after THA and TKA in adults with osteoarthritis. T t METHODS:Five electronic databases were searched from inception to March 3, 2015. All study designs objectively measuring PA before and after THA or TKA were eligible, including randomized controlled trials, cohort studies, and case-control studies. Two reviewers independently screened abstracts and full texts and extracted study demographic, PA, and clinical outcome data. Standardized mean differences (SMDs) and 95% confidence intervals were calculated for accelerometer-and pedometer-derived estimates of PA. Risk of methodological bias was assessed with Critical Appraisal Skills Programme checklists. T t RESULTS:Eight studies with a total of 373 participants (238 TKA, 135 THA) were included. Findings were mixed regarding improvement in objectively measured PA at 6 months after THA (SMDs, -0.20 to 1.80) and TKA (SMDs, -0.36 to 0.63). Larger improvements from 2 studies at 1 year postsurgery were generally observed after THA (SMDs, 0.39 to 0.79) and TKA (SMDs, 0.10 to 0.85). However, at 1 year, PA levels were still considerably lower than those of healthy controls (THA SMDs, -0.25 to -0.77; TKA SMDs, -1.46 to -1.80). Risk-of-bias scores ranged from 3 to 9 out of 11 (27%-82%) for cohort studies, and from 3 to 8 out of 10 (30%-80%) for case-control studies. T t CONCLUSION:The best available evidence indicates negligible changes in PA at 6 months after THA or TKA, with limited evidence for larger changes at 1 year after surgery. In the 4 studies that reported control-group data, postoperative PA levels were still considerably less than those of healthy controls. Improved perioperative strategies to instill behavioral change are required to narrow the gap between patient-perceived functional improvement and the actual amount of PA undertaken after THA and TKA. Registered with PROSPE-RO (registration number CRD42014010155). T t LEVEL OF EVIDENCE:Therapy, level 2a.

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The trajectory of recovery and the inter-relationships of symptoms, activity and participation in the first year following total hip and knee replacement

Cited by 86 publications

References 40 publications

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Does Clinically Important Change in Function After Knee Replacement Guarantee Good Absolute Function? The Multicenter Osteoarthritis Study

Does Physical Activity Increase After Total Hip or Knee Arthroplasty for Osteoarthritis? A Systematic Review

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