Patient reported outcomes do not correlate to functional knee recovery and range of motion in total knee arthroplasty

Abstract

BackgroundMany total knee arthroplasty (TKA) patients exhibit continued pain and limited function following surgery. Determining TKA outcomes is typically reliant on post-operative evaluations and completing patient-reported outcomes (PROMs). Due to low compliance rates, it is essential to identify new strategies for monitoring patients. The purpose of this analysis was to assess the correlations between gait kinematics, PROMs, and knee range of motion (ROM). Methods130 patients (75 female) received Persona IQ TKA (Zimmer Biomet, Warsaw, IN, USA) which includes a stem extension with embedded accelerometer and gyroscope. PROM scores were compared at baseline and 6 weeks post-TKA using a paired t-test. Gait kinematics were recorded daily via the Persona IQ stem extension. Pearson's correlation coefficients were derived between PROMs and average gait kinematics. ResultsKnee Injury and Osteoarthritis Outcome Score (KOOS Jr.) and Veterans RAND 12 (VR-12) physical scores improved following surgery (p ≤ 0.001, p = 0.003, respectively). Weak statistically significant correlations were found between PROMS and gait kinematics. ConclusionWeak correlations between PROMs and gait kinematics indicate patient perception of improvement and objectively measured functional status may not be interchangeable. Further, compliance with Persona IQ data reached 95.4–97.7% (depending on the parameter) at 6 weeks following surgery, a 20% higher compliance rate over PROMs. Daily functional measurements provide insight into the patient's progression and may be useful in detecting poor outcomes.