Assessing Recovery and Establishing Prognosis Following Total Knee Arthroplasty

Abstract

The greatest improvement occurred in the first 12 weeks after TKA. Slower improvement continued to occur from 12 weeks to 26 weeks after TKA, and little improvement occurred beyond 26 weeks after TKA. The findings can be used by physical therapists to make prognostic judgments related to the expected rate of improvement following TKA and the total amount of improvement that may be expected.

Does Concomitant Low Back Pain Affect Revision Total Knee Arthroplasty Outcomes?

“…Although all patients, regardless of comorbidity status, improved in most functional outcomes measures during the first year after undergoing rev-TKA, which is consistent with results from prior studies [6,9,10,15,17], orthopaedic surgeons recommending revision knee arthroplasty should alert patients with low back pain to the possibility of slower or less complete recovery. Doing so could contribute to improved patient satisfaction with this procedure and more involved participation by patients in their postoperative treatment.…”

Preoperative Pain Catastrophizing Predicts Pain Outcome after Knee Arthroplasty

“…We chose 6 months because it captures the preponderance, if not essentially all, of the improvement associated with knee arthroplasty while avoiding earlier postoperative differences in pain perception, which might be ascribed to differences in wound healing, physical conditioning, or physical therapy protocols. Changes in WOMAC pain or function scores after 6 months of recovery are negligible in one study [29] or only 1 or 2 WOMAC points in other studies [13,33].…”

“…First, we followed patients for only 6 months after surgery. Although evidence suggests outcomes at 6 months and those at 1 or 2 years are similar, with either no difference or only a 1-or 2-WOMAC point change [10,13,29,33], a longer-term followup may have shown differences compared with those at 6 months. Second, our sample size was smaller than some cohort studies [10,33].…”

Do Activity Levels Increase After Total Hip and Knee Arthroplasty?

“…Further research is required to determine the most accurate activity count cut points to use in an arthroplasty population. We chose 6 months postoperatively because the largest improvements in all aspects of physical function and self-reported outcomes after THA or TKA typically occur by this time [25,26,35,36,43]. However, longer timeframes may be required for improvements in physical function to translate into increases in physical activity after arthroplasty.…”