Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported function
Purpose The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2017-11, Vol.25 (11), p.3378-3386 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Naili, Josefine E. Iversen, Maura D. Esbjörnsson, Anna-Clara Hedström, Margareta Schwartz, Michael H. Häger, Charlotte K. Broström, Eva W. |
| description | Purpose
The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.
Methods
A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.
Results
Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5–1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.
Conclusion
Measures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.
Level of evidence
II. |
| doi_str_mv | 10.1007/s00167-016-4234-7 |
| format | Article |
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The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.
Methods
A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.
Results
Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5–1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.
Conclusion
Measures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.
Level of evidence
II.</description><identifier>ISSN: 0942-2056</identifier><identifier>ISSN: 1433-7347</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-016-4234-7</identifier><identifier>PMID: 27436196</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Arthritis ; arthroplasty ; Arthroplasty (knee) ; Arthroplasty, Replacement, Knee - adverse effects ; Arthroplasty, Replacement, Knee - methods ; Arthroplasty, Replacement, Knee - rehabilitation ; Biocompatibility ; biomechanics ; Biomedical materials ; Change detection ; Female ; function ; Gait ; Humans ; Joint surgery ; Kinematics ; Knee ; knee osteoarthritis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; mobile bearing ; Mobility Limitation ; Orthopedics ; Osteoarthritis ; Osteoarthritis, Knee - surgery ; outcome ; patient ; Patients ; Physiotherapy ; Prospective Studies ; Recovery of Function ; reported outcome ; Self Report ; sjukgymnastik ; Surgery ; Surgical implants ; Three dimensional analysis</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017-11, Vol.25 (11), p.3378-3386</ispartof><rights>The Author(s) 2016</rights><rights>Knee Surgery, Sports Traumatology, Arthroscopy is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c546t-e1640586defe6fd5b0f73cc9ebe84aba1209a5eed7710875710539d093cb49333</citedby><cites>FETCH-LOGICAL-c546t-e1640586defe6fd5b0f73cc9ebe84aba1209a5eed7710875710539d093cb49333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-016-4234-7$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-016-4234-7$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27436196$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-124829$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:136893254$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Naili, Josefine E.</creatorcontrib><creatorcontrib>Iversen, Maura D.</creatorcontrib><creatorcontrib>Esbjörnsson, Anna-Clara</creatorcontrib><creatorcontrib>Hedström, Margareta</creatorcontrib><creatorcontrib>Schwartz, Michael H.</creatorcontrib><creatorcontrib>Häger, Charlotte K.</creatorcontrib><creatorcontrib>Broström, Eva W.</creatorcontrib><title>Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported function</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.
Methods
A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.
Results
Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5–1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.
Conclusion
Measures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.
Level of evidence
II.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthritis</subject><subject>arthroplasty</subject><subject>Arthroplasty (knee)</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Arthroplasty, Replacement, Knee - rehabilitation</subject><subject>Biocompatibility</subject><subject>biomechanics</subject><subject>Biomedical materials</subject><subject>Change detection</subject><subject>Female</subject><subject>function</subject><subject>Gait</subject><subject>Humans</subject><subject>Joint surgery</subject><subject>Kinematics</subject><subject>Knee</subject><subject>knee osteoarthritis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>mobile bearing</subject><subject>Mobility Limitation</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>outcome</subject><subject>patient</subject><subject>Patients</subject><subject>Physiotherapy</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>reported outcome</subject><subject>Self Report</subject><subject>sjukgymnastik</subject><subject>Surgery</subject><subject>Surgical implants</subject><subject>Three dimensional analysis</subject><issn>0942-2056</issn><issn>1433-7347</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>D8T</sourceid><recordid>eNp9ks9vFSEQx4nR2Gf1D_BiSLx4WeXXwnIxaVqrJk28qFfCY2dfaXdhBbbm-deXl_fatCZ6GQbmM98ZYBB6Tcl7Soj6kAmhUjXVNIJx0agnaEUF543iQj1FK6IFaxhp5RF6kfMVIdUV-jk6YkpwSbVcoT9nMHjnS8Y-4GEJrvgY7IhnSENMkw0OsA093lhfcAyAt2ATtkOBhEsslbwOUJFULlOcR5vLFveQZ18A-2lO8QZ6nGEcmgRzTKXu7qq8RM8GO2Z4dViP0Y_zT99PvzQX3z5_PT25aFwrZGmASkHaTvYwgBz6dk0GxZ3TsIZO2LWljGjbAvRKUdKpttqW655o7tZCc86PUbPXzb9hXtZmTn6yaWui9eZwdF09MC3hisv_8mf-54mJaWOWaTGUiY7pyn_c8xWeoHcQSrLjo7THkeAvzSbemPoZQnaiCrw7CKT4a4FczOSzg3G0AeKSDe2YVExoSSr69i_0Ki6pflildEtb2nG964juKZdizgmG-2YoMbvJMfvJMdWY3eQYVXPePLzFfcbdqFSAHZ6lhsIG0oPS_1S9BS4P0lQ</recordid><startdate>20171101</startdate><enddate>20171101</enddate><creator>Naili, Josefine E.</creator><creator>Iversen, Maura D.</creator><creator>Esbjörnsson, Anna-Clara</creator><creator>Hedström, Margareta</creator><creator>Schwartz, Michael H.</creator><creator>Häger, Charlotte K.</creator><creator>Broström, Eva W.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADHXS</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D93</scope><scope>ZZAVC</scope></search><sort><creationdate>20171101</creationdate><title>Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported function</title><author>Naili, Josefine E. ; Iversen, Maura D. ; Esbjörnsson, Anna-Clara ; Hedström, Margareta ; Schwartz, Michael H. ; Häger, Charlotte K. ; Broström, Eva W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c546t-e1640586defe6fd5b0f73cc9ebe84aba1209a5eed7710875710539d093cb49333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthritis</topic><topic>arthroplasty</topic><topic>Arthroplasty (knee)</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Arthroplasty, Replacement, Knee - rehabilitation</topic><topic>Biocompatibility</topic><topic>biomechanics</topic><topic>Biomedical materials</topic><topic>Change detection</topic><topic>Female</topic><topic>function</topic><topic>Gait</topic><topic>Humans</topic><topic>Joint surgery</topic><topic>Kinematics</topic><topic>Knee</topic><topic>knee osteoarthritis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>mobile bearing</topic><topic>Mobility Limitation</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>outcome</topic><topic>patient</topic><topic>Patients</topic><topic>Physiotherapy</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>reported outcome</topic><topic>Self Report</topic><topic>sjukgymnastik</topic><topic>Surgery</topic><topic>Surgical implants</topic><topic>Three dimensional analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Naili, Josefine E.</creatorcontrib><creatorcontrib>Iversen, Maura D.</creatorcontrib><creatorcontrib>Esbjörnsson, Anna-Clara</creatorcontrib><creatorcontrib>Hedström, Margareta</creatorcontrib><creatorcontrib>Schwartz, Michael H.</creatorcontrib><creatorcontrib>Häger, Charlotte K.</creatorcontrib><creatorcontrib>Broström, Eva W.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SWEPUB Umeå universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Umeå universitet</collection><collection>SwePub Articles full text</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naili, Josefine E.</au><au>Iversen, Maura D.</au><au>Esbjörnsson, Anna-Clara</au><au>Hedström, Margareta</au><au>Schwartz, Michael H.</au><au>Häger, Charlotte K.</au><au>Broström, Eva W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported function</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2017-11-01</date><risdate>2017</risdate><volume>25</volume><issue>11</issue><spage>3378</spage><epage>3386</epage><pages>3378-3386</pages><issn>0942-2056</issn><issn>1433-7347</issn><eissn>1433-7347</eissn><abstract>Purpose
The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.
Methods
A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.
Results
Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5–1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.
Conclusion
Measures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.
Level of evidence
II.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27436196</pmid><doi>10.1007/s00167-016-4234-7</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017-11, Vol.25 (11), p.3378-3386 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals; SWEPUB Freely available online |
| subjects | Aged Aged, 80 and over Arthritis arthroplasty Arthroplasty (knee) Arthroplasty, Replacement, Knee - adverse effects Arthroplasty, Replacement, Knee - methods Arthroplasty, Replacement, Knee - rehabilitation Biocompatibility biomechanics Biomedical materials Change detection Female function Gait Humans Joint surgery Kinematics Knee knee osteoarthritis Male Medicine Medicine & Public Health Middle Aged mobile bearing Mobility Limitation Orthopedics Osteoarthritis Osteoarthritis, Knee - surgery outcome patient Patients Physiotherapy Prospective Studies Recovery of Function reported outcome Self Report sjukgymnastik Surgery Surgical implants Three dimensional analysis |
| title | Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported function |
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