Sports Activity after Low-contact-stress Total Knee Arthroplasty – A long term follow-up study

Vielgut, Ines; Leitner, Lukas; Kastner, Norbert; Radl, Roman; Leithner, Andreas; Sadoghi, Patrick

doi:10.1038/srep24630

Cited by 26 publications

(36 citation statements)

References 33 publications

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“…Lim and colleagues also found no statistically significant difference in the change of function scores over time for both UKA and TKA [33]. Consistent with that, the other authors confirmed an association between better preoperative scores and better postoperative scores [34,35]. By examining patient-reported outcome measures from the National Joint Registry of England and Wales (NJR), no difference was found in the improvement of either knee-specific or general health outcomes between UKA and TKA in a large cohort [36].…”

Section: Discussionmentioning

confidence: 58%

Greater activity, better range of motion and higher quality of life following unicompartmental knee arthroplasty: a comparative case–control study

Hauer

Sadoghi

Bernhardt

et al. 2019

Arch Orthop Trauma Surg

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Purpose The purpose of this study was to provide a matched cohort comparison of clinical and functional outcome scores, range of motion and quality of life following unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). The hypothesis was that patients receiving UKA report better results than comparable patients who receive conventional TKA. Methods Clinical and functional results of 35 patients with medial end-stage osteoarthritis who had received a fixed-bearing UKA were compared with the results of 35 matched patients who had received a TKA from the same manufacturer by the same surgeon. Outcome scores were measured before surgery and at final follow-up using Tegner Activity Scale (TAS), range of motion (ROM) and Short Form 36 Health Survey (SF-36). The Knee Society Score (KSS) was assessed at final follow-up. The mean observation period was 2.3 years in both groups. Results The preoperative knee scores had no statistically significant differences between the two groups. Postoperatively, however, UKAs performed significantly better regarding TAS and ROM (4 vs. 3 and 118.4 vs. 103.7, respectively). The results of the SF-36 showed significantly better results for the UKA group in the mental component summary score and in the subscale of social function. Conclusions The present study suggests that UKA is associated with higher activity level, higher quality of life, and greater ROM when compared with TKA on comparable patients. Prolonged clinical follow-up in a larger patient cohort with a randomised-controlled study design would be beneficial to confirm these findings. Level of evidence III.

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Section: Discussionmentioning

confidence: 58%

Greater activity, better range of motion and higher quality of life following unicompartmental knee arthroplasty: a comparative case–control study

Hauer

Sadoghi

Bernhardt

et al. 2019

Arch Orthop Trauma Surg

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“…No effective treatments are currently available to prevent or reverse OA progression 12 , but total knee arthroplasty (TKA) is a common surgical intervention for treating end-stage knee OA. TKA aims to relieve pain, restore loco-motor functions, correct deformities and improve quality of life 13 . Patients with knee OA undergoing TKA often present with residual functional deficits, and one important area of concern is balance impairments, which increase the risk of falls in these patients 14 – 17 .…”

Section: Introductionmentioning

confidence: 99%

The effect of primary total knee arthroplasty on the incidence of falls and balance-related functions in patients with osteoarthritis

Zeng

Zhong

et al. 2017

Sci Rep

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Knee osteoarthritis (OA) is an established risk factor for falls and balance impairment. This study investigated the incidence of falls, balance-related outcomes and risk factors for falls before and after primary total knee arthroplasty (TKA). Three hundred seventy-six OA patients scheduled to undergo TKA were included. Falls data within the preoperative, first postoperative and second postoperative years were collected, balance-related functions were assessed using the Assessment of Quality of Life (AQoL), WOMAC, Falls Efficacy Scale International (FES-I), Activities-specific Balance Confidence (ABC), knee extension strength, Berg Balance Scale (BBS) and Timed Up and Go (TUG) before surgery and 1 and 2 years after surgery. Compared with preoperative values, the incidence of falls significantly decreased (14.89%, 6.23% and 3.14% within the preoperative, first postoperative and second postoperative years, respectively) and the AQoL, WOMAC, FES-I, ABC, knee extension strength, BBS and TUG significantly improved after TKA. Logistic regression analysis revealed that Kellgren-Lawrence grade ≥ 3 of the contralateral knee was an independent risk factor for falls before and after TKA. Conclusively, primary TKA is associated with a reduced incidence of falls and improved balance-related functions, and the contralateral knee should be considered in the design of fall-prevention strategies in patients with OA.

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“…Ähnlich wie in der Hüftendoprothetik zeigt die Literatur sowohl nach UKA und TKA eine deutliche Verschiebung von High-impact-Sportarten zu Low-impact-Sportarten, wobei dieser Trend nach TKA stärker ausgeprägt ist [13]. Eine aktuelle Arbeit von Vielgut et al hat die Sportpartizipation von 236 Patienten im Langzeitverlauf nach einem mittleren Follow-up von 14,9 Jahren nach TKA beschrieben [57]. Immerhin 71 % der Patienten waren 15 Jahre post-OP noch sportlich aktiv, jedoch war auch hier eine deutliche Verschiebung hin zum low impact zu verzeichnen: von den Patienten, die prä-OP Highimpact-Sport betrieben hatten, waren es post-OP nur noch 16 %, von denen mit Intermediate-impact-Sport noch 44 %, von denen mit Low-impact-Sport noch 71 %.…”

Section: Knieendoprothetik: Allgemeine Sportfähigkeitunclassified

Endoprothetischer Gelenkersatz und Sport

Oehler

Schmidt

Niemeier

2017

Phys Med Rehab Kuror

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Zusammenfassung Hintergrund Es finden sich zunehmend Patienten mit sportlichem Funktionsanspruch, für die nicht nur die Frage nach grundsätzlicher Sportfähigkeit nach Endoprothesenimplantation, sondern auch nach dem erreichbaren Sportniveau im Sinne der Rückkehr zu präoperativer sportlicher Aktivität bedeutsam ist. Dieser Artikel soll einen Überblick über neuere Daten zu folgenden Fragen hinsichtlich Hüft-, Knie und Schulterendoprothetik geben: (1) Welche Auswirkungen hat sportliche Aktivität auf Endoprothesen? (2) Welches Sportniveau ist nach endoprothetischer Versorgung erreichbar? (3) Welche Empfehlungen können zu sportlicher Aktivität mit Endoprothese gegeben werden? Methoden PubMed basierte Literaturrecherche. Narrativer Review mit Fokus auf aktuellen Daten aus den Jahren 2010–2016. Ergebnisse Die allgemein bekannte Empfehlung zu Low-impact-Sportarten mit moderater Intensität wie Wandern, Schwimmen, Radfahren, Golfbehält ihre Gültigkeit für sämtliche Prothesentypen an allen Gelenken. Hier ist unstrittig, dass die positiven die negativen Effekte überwiegen. Nach Implantation von HTEP und KTEP findet die Mehrheit der prä-OP aktiven Patienten nach 3–6 Monaten wieder zu sportlicher Aktivität zurück, wenn auch mit klarer Tendenz zu niedrigerer Intensität und einer Verschiebung von high impact hin zu low impact. Wichtige offene Fragen beziehen sich auf die Effekte von mit hoher Intensität betriebenen Low-impact-Sportarten, auf High-impact-Sportarten, auf sportartspezifische Wirkungen sowie auf prothesentypspezifische Möglichkeiten. Hier sind die Grenzen zwischen positiven und negativen Effekten von sportlicher Belastung unterschiedlicher Intensität erst beginnend untersucht. Neue Daten weisen darauf hin, dass allgemein eine höhere sportliche Leistungsfähigkeit erreichbar ist, als traditionell empfohlen wird. Frühe Ergebnisse unikondylärer Knieprothesen übertreffen die bikondylärer Prothesen deutlich. Schulterendoprothesen zeigen entgegengesetzt zu Expertenempfehlungen die höchsten postoperativen Aktivitätslevel nach inverser und anatomischer TEP und die geringste Sportaktivität nach Hemiprothesen. Schlussfolgerung Bisherige Expertenempfehlungen und faktische Möglichkeiten des Sportniveaus nach Endoprothesenimplantation divergieren z. T. erheblich. Es bleibt durch zukünftige Studien zu definieren, welches Sportniveau unter Verwendung moderner abriebarmer Gleitpaarungen und Prothesendesigns in welcher Sportart mit welcher Prothese ein positives Nutzen-Risiko-Verhältnis darstellt.

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Sports Activity after Low-contact-stress Total Knee Arthroplasty – A long term follow-up study

Cited by 26 publications

References 33 publications

Greater activity, better range of motion and higher quality of life following unicompartmental knee arthroplasty: a comparative case–control study

Greater activity, better range of motion and higher quality of life following unicompartmental knee arthroplasty: a comparative case–control study

The effect of primary total knee arthroplasty on the incidence of falls and balance-related functions in patients with osteoarthritis

Endoprothetischer Gelenkersatz und Sport

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