Abstract
PurposeA total knee arthroplasty (TKA) is a cost-effective option to relieve pain and improve knee function in patients suffering from osteoarthritis. However, results differ among patients. The predictive value of pre-surgically assessed factors on the level of functioning after 3 and 12 months was investigated in this study.MethodsThis study used an inception cohort design and a follow-up of 12 months. One hundred and fifty patients who were to receive a TKA were assessed pre-surgically with an International Classification of Functioning, Disability and Health (ICF) core assessment set: Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short-Form 12 (SF12), Patient-Specific Function Scale (PSFS), range of motion (ROM), quadriceps and hamstring strength and gait parameters. The main outcome measure was WOMAC-Function at 3 and 12 months after surgery.ResultsPre-surgical physical and mental health on the SF12 and functioning and stiffness on the WOMAC explained 23% of the variance in the level of functioning 3 months after surgery. Pre-surgical knee function measured with the KSS-Knee, and functioning as assessed by WOMAC-Function explained 16% of the variance of the level of functioning 12 months after surgery.ConclusionsThe results of this study show that better functioning before surgery, less knee stiffness and a better physical and mental health to some extent predict better functioning 3 months after surgery. This effect is less evident at 12 months. This study is clinically relevant since it provides benchmark data for health care providers who want to compare their individual patients.Level of evidenceII.
Highlights
Several studies have investigated the influence of pre-surgical predictors on functional status post surgery
Our hypothesis was that taking account of pre-surgical functional parameters and self-report questionnaires assessing the ‘function’ and ‘disability’ domains of the International Classification of Functioning, Disability and Health model (ICF) would make the prediction models more complete
The results of the univariate regression analysis including pre-surgical parameters and the WOMACF are presented in Appendix Table 5, which only shows the parameters that were significant and retained for multivariate analysis
Summary
Several studies have investigated the influence of pre-surgical predictors on functional status post surgery. Large datasets regarding the pre- and post-surgical functional status of TKA patients are lacking, which makes our study unique. The large study sample enabled us to investigate the relationship between multiple parameters and the post-surgical functional status. Our hypothesis was that taking account of pre-surgical functional parameters and self-report questionnaires assessing the ‘function’ and ‘disability’ domains of the International Classification of Functioning, Disability and Health model (ICF) would make the prediction models more complete. This information could inform clinicians and patients in the pre-surgical process. The hypothesis was that a combination of pre-surgical functions and demographic variables would predict the postsurgical level
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