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The ability to resume physical activities, aerobic fitness and a healthy lifestyle without symptoms after total knee arthroplasty (TKA) remains unclear because studies show high rates of patient dissatisfaction. The aim of this study was to evaluate whether an individualized goal-centered rehabilitation protocol leads to high patient-reported physical activities and satisfaction after TKA.
A prospective study was conducted in patients who underwent primary TKA (Journey II, Smith & Nephew) from the same surgeon from July 1, 2013 to December 31, 2015. Patients completed patient-reported outcome measures (PROMs) before the operation and then at 1, 2, and 4 years postoperatively.These included the Knee Injury and Osteoarthritis Outcome Joint Replacement Survey (KOOS JR) 7-item score; questions from the Cincinnati Knee Rating System related to the overall knee condition, pain, and swelling; selected questions from the Veterans RAND 12-Item Health Survey; questions about general fitness level; and questions regarding patient expectations before and after surgery. Patients were asked to list all physical, recreational, and work activities they participated in after surgery. An experienced research associate interviewed the patients postoperatively, with data reduction and patient ratings blinded to the treating surgeon and therapist.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Total knee arthroplasty | Procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Knee Injury and Osteoarthritis Outcome Joint Replacement Survey (KOOS) Jr 7-item score | Scored on a scale of 0-100 points, where 0 = total disability and 100 = perfect knee health. | Preoperative |
| Knee Injury and Osteoarthritis Outcome Joint Replacement Survey (KOOS) Jr 7-item score | Scored on a scale of 0-100 points, where 0 = total disability and 100 = perfect knee health. | 4 years postoperative |
| Documentation of sports and recreational activities | Patients provide a list of all sports and recreational activities they participated in after surgery. This is an open-ended question "What sports or recreational activities do you participate in on a regular basis?" | 4 years postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Cincinnati Knee Rating Pain Score | Scored on a point scale where patient selects 0, 2, 4, or 6; where 0 = severe pain constant with daily activities, 2 = moderate pain with activities of daily living, 4 = able to do activities of daily living with no pain, and 6 = no pain with recreational activities | Preoperative |
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Inclusion Criteria:
Exclusion Criteria:
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The patients were selected from the treating surgeon's patient population.
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| Name | Affiliation | Role |
|---|---|---|
| Frank R Noyes, MD | Cincinnati Sportsmedicine and Orthopaedic Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cincinnati Sportsmedicine and Orthopaedic Center | Cincinnati | Ohio | 45242 | United States |
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| ID | Term |
|---|---|
| D019645 | Arthroplasty, Replacement, Knee |
| ID | Term |
|---|---|
| D019643 | Arthroplasty, Replacement |
| D001178 | Arthroplasty |
| D019637 | Orthopedic Procedures |
| D013514 | Surgical Procedures, Operative |
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| Cincinnati Knee Rating Pain Score |
Scored on a point scale where patient selects 0, 2, 4, or 6; where 0 = severe pain constant with daily activities, 2 = moderate pain with activities of daily living, 4 = able to do activities of daily living with no pain, and 6 = no pain with recreational activities |
| 4 years postoperative |
| Cincinnati Knee Rating Patient Perception of the Overall Knee Condition Score | Score for the patient rating of the overall knee condition (0-10 point scale where 0 = poor and 10 = excellent) | Preoperative |
| Cincinnati Knee Rating Patient Perception of the Overall Knee Condition Score | Score for the patient rating of the overall knee condition (0-10 point scale where 0 = poor and 10 = excellent) | 4 years postoperative |
| Cincinnati Knee Rating Swelling Score | Scored on a point scale where patient selects 0, 2, 4, or 6; where 0 = severe swelling constant with daily activities, 2 = moderate swelling with activities of daily living, 4 = able to do activities of daily living with no swelling, and 6 = no swelling with recreational activities | Preoperative |
| Cincinnati Knee Rating Swelling Score | Scored on a point scale where patient selects 0, 2, 4, or 6; where 0 = severe swelling constant with daily activities, 2 = moderate swelling with activities of daily living, 4 = able to do activities of daily living with no swelling, and 6 = no swelling with recreational activities | 4 years postoperative |
| Aerobic fitness levels | Two questions are completed:
| Preoperative |
| Aerobic fitness levels | Two questions are completed:
| 4 years postoperative |
| Work Status | Single question: Are you able to work: Patients select: Yes, with no limitations; Yes, with limitations; No, Retired or does not apply | Preoperative |
| Work Status | Single question: Are you able to work: Patients select: Yes, with no limitations; Yes, with limitations; No, Retired or does not apply | 4 years postoperative |
| Patient Expectations After Surgery | 4 questions:
Scale: Great deal better, Somewhat better, The same, Somewhat worse, Great deal worse | 4 years postoperative |
| Patient Expectations Before Surgery | 2 questions:
Scale for both questions: Fully normal with no limitation; Almost normal with some limitations; Improved, but may have some problems; Improved, but may have bothersome problems; Not possible or not interested in recreational activities | Preoperative |
| D019651 | Plastic Surgery Procedures |
| D019919 | Prosthesis Implantation |