title: Do Total Knee Arthroplasty Patients Have a Higher Activity Level Compared to Patients With Osteoarthritis?
abstract: BACKGROUND
  Despite the alleviation of osteoarthritis (OA) symptoms that total knee arthroplasty (TKA) provides for patients with end-stage knee OA, recent studies have suggested that TKA may not increase physical activity levels. In this study, we compare the physical activity levels of patients with OA treated nonoperatively (non-TKA) with both patients who had received TKA (post-TKA) and patients who received TKA within 3 years of data collection (pre-TKA).
  
  
  METHODS
  Utilizing the Osteoarthritis Initiative database, accelerometry data were collected from non-TKA, pre-TKA, and post-TKA patients. Accelerometry data were subdivided by physical activity intensity levels, yielding daily minutes of each level of activity. Physical activity levels were then compared between non-TKA and pre-TKA/post-TKA patients. Physical activity levels for each patient were also compared to the Department of Health and Human Services (DHHS) guidelines for physical activity.
  
  
  RESULTS
  There was no difference in physical activity between non-TKA and pre-TKA patients, with the exception of non-TKA patients achieving more daily minutes of vigorous activity (P < .001). There was no difference in physical activity between non-TKA and post-TKA patients. Although 11.6% of non-TKA patients met DHHS guidelines, only 4.8% of pre-TKA and 5.3% of post-TKA patients met guidelines.
  
  
  CONCLUSIONS
  Despite the improvements in patient-reported outcome measures following TKA, we found that TKA alone does not improve physical activity levels beyond those seen in the average patient with OA. In our study, the vast majority of patients with OA, treated nonoperatively or operatively, did not meet current DHHS guidelines for physical activity.
authors.affiliation: University of California Irvine Medical Center, Orange, CA, USA.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Kahn
authors.affiliation: Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Medical Center Hospital For Joint Diseases, New York, NY, USA.
authors.forename: Ran
authors.initials: R
authors.lastname: Schwarzkopf
keywords: Osteoarthritis Initiative; accelerometer; activity level; osteoarthritis; total knee arthroplasty