[Development of physical and sports activity in patients before and after implantation of a total knee endoprosthesis. A prospective study of 40 patients].
OBJECTIVE
The aim of this prospective study was to analyse the development of activities of daily living (ADL) as well as sports activities in patients suffering from osteoarthritis of the knee and undergoing total knee replacement. 40 patients with 42 operated knee joints were included in this study.


METHODS
38 patients (40 knee replacements) recieved a PFC endoprosthesis, 2 patients recieved a GSB endoprosthesis. In 28 cases (71%) we found generalized degenerative joint changes, in 7 cases (17%) a varus deformity and in 2 cases (5%) a valgus deformity. Post-traumatic osteoarthritis was seen in 3 cases (7%). We used the PFC endoprosthesis in patients with stable ligaments, in unstable joints we used the GSB endoprosthesis. Patients were reviewed clinically and radiographically and answered a questionnaire with special reference to ADL (walking, gymnastics, bicycling, homework, swimming, gardening). For evaluation of the results we used the Ranawat & Shine score. Pain was determined with the VAS (visual analogue pain scale).


RESULTS
The activity level increased from preoperatively 62.5% up to 91.5% 2 years postoperatively. This was mainly due to walking and gymnastics. Overall sports activities decreased. There was a high uncertainty regarding activities due to patients' lack of knowledge about possible postoperative load capacity of the new joint. The average score according to Ranawat & Shine increased from preoperative 56.98 to 75.89 points out of 100. Most significantly we found an improvement in the pain rating. There was an improvement of 73% under resting and of 81% under activity conditions.


CONCLUSIONS
With this prospective study we can demonstrate the benefit for patients undergoing knee replacement surgery with respect to activities of daily living and especially pain reduction.
Münnich
U
U
Abteilung für Medizinische Beratung, Deutschen Krankenversicherung AG, Köln.
König
D P
DP
Popken
F
F
Hackenbroch
M H
MH
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology / Q000534:rehabilitation; D011446:Prospective Studies; D011474:Prosthesis Design; D013177:Sports; D016474:Weight-Bearing