Total knee arthroplasty improves sports activity and the patient-reported functional outcome at mid-term follow-up.

Amit Meena, Christian Hoser, Elisabeth Abermann, Caroline Hepperger, Akshya Raj, Christian Fink
Author Information
  1. Amit Meena: Gelenkpunkt - Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.
  2. Christian Hoser: Gelenkpunkt - Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.
  3. Elisabeth Abermann: Gelenkpunkt - Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.
  4. Caroline Hepperger: Gelenkpunkt - Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.
  5. Akshya Raj: Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029, India.
  6. Christian Fink: Gelenkpunkt - Sports and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria. c.fink@gelenkpunkt.com.

Abstract

PURPOSE: The purpose of this study was to assess (1) sports participation and preference for the type of sports activity after TKA, (2) mid-term functional outcome and activity level, (3) correlation of different age groups with activity level and functional outcomes, and (4) mid-term survivorship of the prosthesis.
METHODS: A retrospective review of prospectively collected data was performed. 182 patients were included who underwent primary TKA between January 2010 and December 2016. Inclusion criteria were symptomatic knee osteoarthritis, age 50-90 years, and with a minimum of 5-year follow-up after TKA. Patients with rheumatoid arthritis and revision TKA were excluded. Sports participation and sports preference, Oxford Knee Score (OKS), Tegner Activity Level, and Visual Analogue Scale (VAS) for pain were recorded pre- and postoperatively at 6 months, 1 year, 2 years, and 5 years. The patient cohort was subdivided according to age groups; activity levels, patient-reported outcomes, and improvement in knee pain were correlated with these age groups. Kaplan-Meier curves were used to investigate survivorship at a minimum of 5 years.
RESULTS: The mean age of the cohort was 75.6 ± 7.2 years (range 52-89). Significant improvement was noted in sports participation (p < 0.003). After TKA, there was no change in the preference for sports and none of the patients had to discontinue their sporting activity. OKS improved significantly at all follow-up time points compared to the preoperative score (p < .0001). Patients' sports and physical activity improved significantly at 1 year compared to the preoperative activity level (p < 0.001). Although the Tegner activity level improved over time, this improvement was not significant (NS), while it was significantly higher in males than in females (p < 0.004). Significant improvement was found in the VAS for pain at all follow-up time points compared to the preoperative score (p < .0001). Survivorship was found to be 100% at a 5-year follow-up.
CONCLUSION: After TKA, patients can be able to return to sporting activity or even perform better than before surgery. Maximum improvement was noted in the first post-operative year. The male and younger groups perform better than the female and older groups. Sports and physical activity do not negatively impact survivorship of the knee prosthesis at mid-term follow-up and all patients are encouraged to take up sports participation after their TKA.
LEVEL OF EVIDENCE: Level 3.

Keywords

References

  1. Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2042-2050 [PMID: 30298413]
  2. SICOT J. 2020;6:11 [PMID: 32378511]
  3. Knee Surg Sports Traumatol Arthrosc. 2018 May;26(5):1515-1523 [PMID: 28341878]
  4. Sci Rep. 2016 Apr 19;6:24630 [PMID: 27090945]
  5. Knee Surg Sports Traumatol Arthrosc. 2018 Jun;26(6):1811-1822 [PMID: 29185005]
  6. Knee Surg Sports Traumatol Arthrosc. 2021 Oct;29(10):3352-3360 [PMID: 32778907]
  7. ANZ J Surg. 2005 Jun;75(6):405-8 [PMID: 15943726]
  8. Best Pract Res Clin Rheumatol. 2019 Feb;33(1):172-187 [PMID: 31431271]
  9. J Bone Joint Surg Br. 2009 Jul;91(7):889-95 [PMID: 19567852]
  10. Qual Life Res. 2017 Feb;26(2):403-417 [PMID: 27492606]
  11. J Arthroplasty. 2020 Aug;35(8):2274-2285.e1 [PMID: 32389409]
  12. Int Orthop. 2021 Aug;45(8):1983-1999 [PMID: 33821306]
  13. Clin Orthop Relat Res. 2007 Jul;460:165-73 [PMID: 17310928]
  14. Scand J Med Sci Sports. 2015 Aug;25 Suppl 2:3-9 [PMID: 26083696]
  15. Orthop J Sports Med. 2015 Apr 20;3(4):2325967115579171 [PMID: 26665054]
  16. EFORT Open Rev. 2017 Dec 15;2(12):496-501 [PMID: 29387472]
  17. Knee Surg Sports Traumatol Arthrosc. 2022 Feb;30(2):603-611 [PMID: 33151364]
  18. BMJ Open Sport Exerc Med. 2020 Jun 23;6(1):e000729 [PMID: 32597907]
  19. J Sci Med Sport. 2019 Jun;22(6):629-634 [PMID: 30587436]
  20. Knee Surg Sports Traumatol Arthrosc. 2021 Mar;29(3):694-709 [PMID: 33404817]
  21. J Arthroplasty. 2022 May;37(5):985-992.e3 [PMID: 35121088]

MeSH Term

Humans
Male
Female
Middle Aged
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee
Follow-Up Studies
Treatment Outcome
Knee Prosthesis
Knee Joint
Osteoarthritis, Knee
Patient Reported Outcome Measures
Retrospective Studies
Reoperation

Word Cloud

Created with Highcharts 10.0.0activitysportsTKAfollow-upagegroupskneeimprovementparticipationmid-termlevelpatientspreferencefunctionaloutcomesurvivorshipSportspainp < 0improvedsignificantlytimecomparedpreoperative3outcomesprosthesisminimum5-yearOKSTegnerLevelVAS1 year2 years5 yearscohortpatient-reportedSignificantnotedsportingpointsscorep <0001physicalfoundSurvivorshipperformbetterTotalarthroplastyPURPOSE:purposestudyassess1type2correlationdifferent4METHODS:retrospectivereviewprospectivelycollecteddataperformed182includedunderwentprimaryJanuary2010December2016Inclusioncriteriasymptomaticosteoarthritis50-90 yearsPatientsrheumatoidarthritisrevisionexcludedOxfordKneeScoreActivityVisualAnalogueScalerecordedpre-postoperatively6 monthspatientsubdividedaccordinglevelscorrelatedKaplan-MeiercurvesusedinvestigateRESULTS:mean756 ± 7range52-89003changenonediscontinuePatients'001AlthoughsignificantNShighermalesfemales004100%CONCLUSION:canablereturnevensurgeryMaximumfirstpost-operativeyearmaleyoungerfemaleoldernegativelyimpactencouragedtakeLEVELOFEVIDENCE:improvesFunctionalTotal knee replacement  TKR

Similar Articles

Cited By