title: Recovery in knee range of motion reaches a plateau by 12 months after total knee arthroplasty.
abstract: OBJECTIVE
  The primary aim of this study was to identify the time point at which improvements in knee range of motion reach a plateau, if any. The secondary aim of this study was to investigate the correlation between the improvements in knee range of motion and patient-reported outcomes [Oxford knee score (OKS) and SF-36]. The hypothesis is that there is a time point at which the recovery in the knee range of motion after total knee arthroplasty (TKA) plateaus.
  
  
  METHODS
  A prospective study of 145 patients who underwent TKA was conducted. All TKAs were performed by the same surgeon. OKS and SF-36 scores were measured preoperatively and at 6, 12, and 24 months. Range of motion was measured preoperatively and at 1, 3, 6, 12, and 24 months postoperatively.
  
  
  RESULTS
  This study shows that for surgeon/therapist reported range of motion, a plateau in recovery was reached at 12 months after TKA. It was also found that range of extension is significantly correlated with OKS, whereas range of flexion was not significantly correlated with OKS.
  
  
  CONCLUSIONS
  Knowledge of when patients fully recover after TKA will allow appropriate counseling of patients during preoperative consultation. Also, this knowledge will enable surgeons/therapists to better monitor the rehabilitation progress of TKA patients, and make adjustments to the rehabilitation protocol. In addition, our study shows that objective surgeon-/therapist-measured outcome (range of motion) has a significant correlation with subjective patient-reported outcomes (OKS). Hence, both outcome measures should be employed in the postoperative monitoring of patient progress.
  
  
  METHODS
  Prospective case series, Level IV.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Academia Level 4, 20 College Road, Singapore, 169856, Singapore, zhouzhihong0@gmail.com.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Zhou
authors.forename: Khye Soon Andy
authors.initials: KS
authors.lastname: Yew
authors.forename: Earnest
authors.initials: E
authors.lastname: Arul
authors.forename: Pak-Lin
authors.initials: PL
authors.lastname: Chin
authors.forename: Keng Jin Darren
authors.initials: KJ
authors.lastname: Tay
authors.forename: Ngai-Nung
authors.initials: NN
authors.lastname: Lo
authors.forename: Shi-Lu
authors.initials: SL
authors.lastname: Chia
authors.forename: Seng Jin
authors.initials: SJ
authors.lastname: Yeo
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*