Total Knee Arthroplasty Improved Locomotive Syndrome in Knee Osteoarthritis Patients: A Prospective Cohort Study Focused on Total Clinical Decision Limits Stage 3

Abstract

Purpose. The purpose of this study is to investigate the treatment efficacy of total knee arthroplasty (TKA) on locomotive syndrome (LS) focusing on total clinical decision limit (CDL) stage 3 leading to revealing the motor function indicators that can predict LS improvement in knee osteoarthritis patients who had received TKA. Methods. This prospective cohort study was conducted in 47 patients evaluated as total CDL stage 3 before TKA who received primary TKA on the operated side and were diagnosed with Kellgren-Lawrence grade 2, 3, or 4 knee osteoarthritis on the nonoperated side. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA. Results. Of the 47 subjects who were evaluated to be in total CDL stage 3 before TKA, 13 patients (27.7%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 83.3%. Even if the CDL of the two-step test before TKA was higher than 1 and if the 3 m-Timed Up and Go test (3m-TUG) before TKA was 9.6 or less, the improvement rate was 50%. Conclusions. As of three months after surgery, TKA can improve LS in about 30% of knee osteoarthritis patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.

HURWA robotic-assisted total knee arthroplasty improves component positioning and alignment – A prospective randomized and multicenter study

“…KOA is one of the common joint diseases in the elderly and it is also the main cause of knee pain and functional limitation in the elderly [ 34 , 35 ]. TKA is a relative successful and effective method for relieving pain and functional recovery of end-stage knee osteoarthritis, which has been widely carried out worldwide [ 9 , 36 ]. Reconstruction of good lower limb alignment is one of the main purposes of TKA, and it is also an important guarantee of patient satisfaction and prosthesis survival rate after TKA [ 37 , 38 ].…”

“…The prevalence of KOA is expected to be on the rise due to the expanding aging population [ 3 ]. Total knee arthroplasty (TKA) is the best method for the treatment of late-stage KOA [ [9] , [10] , [11] , [12] ]. In China, over 370,000 TKAs were performed each year with an annual growth rate of 15% [ 13 ].…”

Can the measurement of Locomo Age improve motivation for exercise in fitness club users?

“…12 The prevention and treatment of LS included exercise, 13 nutrition, 14,15 and total joint arthroplasty. [16][17][18] For exercise or nutrition, improving motivation is one of the most important issues. A concern was that having a higher Locomo Age than expected would decrease the patients' motivation.…”

“…Previous reports showed that as LS stages progressed, the risk of falls increased, 10 the quality of life decreased, 11 and mortality increased 12 . The prevention and treatment of LS included exercise, 13 nutrition, 14,15 and total joint arthroplasty 16–18 . For exercise or nutrition, improving motivation is one of the most important issues.…”

The impact of spinal surgery on the locomotive syndrome in patients with lumbar spinal stenosis in CDL stage 3: a retrospective study

“…It has been reported that surgical treatment of knee joint [13] and hip joint disease [3] can improve the condition of patients in CDL Stage 3, but there have been few reports on lumbar degenerative diseases. Therefore, this study aimed to investigate the efficacy of lumbar spinal surgery for patients with LSS in CDL stage 3 and the preoperative factors associated with the improvement of the CDL stage.…”