title: Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes.
abstract: The purpose was to explore the responsiveness of both patient-report and performance-based outcome measures to determine functional changes during the acute and long-term postoperative recovery after total knee arthroplasty (TKA). One hundred patients scheduled for unilateral TKA underwent testing preoperatively and at 1 and 12 months postoperatively using the Delaware Osteoarthritis Profile. All physical performance measures decreased initially after surgery then increased in the long term; however, the perceived function did not follow the same trend, and some showed an increase immediately after surgery. Patient-report measures were variable, with no to small response early, but had excellent long-term responsiveness that was twice as large as performance measures. Patient perception fails to capture the acute functional declines after TKA and may overstate the long-term functional improvement with surgery.
authors.affiliation: Department of Physical Therapy, University of Delaware, 301 McKinly Laboratory, Newark, Delaware 19716, USA.
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Mizner
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Petterson
authors.forename: Katie E
authors.initials: KE
authors.lastname: Clements
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Zeni
authors.forename: James J
authors.initials: JJ
authors.lastname: Irrgang
authors.forename: Lynn
authors.initials: L
authors.lastname: Snyder-Mackler
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000601:surgery*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010149:Postoperative Pain; D016059:Range of Motion, Articular / Q000502:physiology*; D015203:Reproducibility of Results; D012649:Self Concept; D057566:Self Report; D016896:Treatment Outcome