Assessing recovery and establishing prognosis following total knee arthroplasty.
OBJECTIVE
Information about expected rate of change after arthroplasty is critical for making prognostic decisions related to rehabilitation. The goals of this study were: (1) to describe the pattern of change in lower-extremity functional status of patients over a 1-year period after total knee arthroplasty (TKA) and (2) to describe the effect of preoperative functional status on change over time.


METHODS
Eighty-four patients (44 female, 40 male) with osteoarthritis, mean age of 66 years (SD=9), participated.


METHODS
Repeated measurements for the Lower Extremity Functional Scale (LEFS) and the Six-Minute Walk Test (6MWT) were taken over a 1-year period. Data were plotted to examine the pattern of change over time. Different models of recovery were explored using nonlinear mixed-effects modeling that accounted for preoperative status and gender.


RESULTS
Growth curves were generated that depict the rate and amount of change in LEFS scores and 6MWT distances up to 1 year following TKA. The curves account for preoperative status and gender differences across participants.


CONCLUSIONS
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.
Kennedy
Deborah M
DM
Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley St E, Toronto, Ontario, Canada M4Y 1H1. d.kennedy@utoronto.ca
Stratford
Paul W
PW
Riddle
Daniel L
DL
Hanna
Steven E
SE
Gollish
Jeffrey D
JD
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D015331:Cohort Studies; D005080:Exercise Test; D005260:Female; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors; D016138:Walking / Q000502:physiology*