Patients who underwent total hip or knee arthroplasty are more physically active than the general Dutch population

J M T A Meessen,W F Peter,H M J Van Der Linden,M R Bénard,H M Vermeulen,R Tordoir,R G H H Nelissen,T P M Vliet Vlieland,R Wolterbeek,R Onstenk,C Tilbury,S C Cannegieter,S B Vehmeijer,S H M Verdegaal

doi:10.1007/s00296-016-3598-9

Abstract

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) bring relief of pain and functional disability to patients with end-stage osteoarthritis, and however, the literature on their impact on patients’ level of physical activity (PA) is scarce. Cross-sectional study in patients who underwent THA/TKA surgery in the preceding 6–22 months and a random sample of persons aged >40 years from the Dutch general population, participating in a national survey. PA in minutes per week (min/week) and adherence to the Dutch recommendation for PA (NNGB yes/no) were measured by the short questionnaire to assess health-enhancing PA. Multivariable linear (total min/week) and logistic regression analyses (meeting recommendations PA), adjusting for confounders, were performed for THA and TKA separately. In total, 258 THA [62.3% female, aged 69.4 (9.1)] and 221 TKA [65.7% female, aged 69.5 (8.9)] patients and 4373 persons from the Dutch general population [51.4% female, aged 58.9 (11.6)] were included. The presence of THA was associated after adjusting for age, sex, BMI education and musculoskeletal comorbidities, with more total min/week spent on PA (THA 13.8% increase, 95% CI 1.6–27.6%), whilst both TJA groups were associated with adhering to NNGB (THA: OR 1.79, 95% CI 1.26–2.56; TKA: OR 1.73, 95% CI 1.20–2.51). As this study used questionnaires to compare the PA of THA/TKA patients to the general population, some recall and selection bias might have been induced. After surgery, overall, TJA patients are more likely to adhere NNGB than a representative sample of persons >40 years from the Dutch general population.

Highlights

Worldwide, the numbers of patients undergoing total hip or total knee arthroplasty (THA or TKA) for hip or knee osteoarthritis (OA) are rapidly increasing
The presence of Total hip arthroplasty (THA) was associated after adjusting for age, sex, body mass index (BMI) education and musculoskeletal comorbidities, with more total min/week spent on physical activity (PA) (THA 13.8% increase, 95% confidence interval (CI) 1.6–27.6%), whilst both total joint arthroplasty (TJA) groups were associated with adhering to NNGB (THA: odds ratio (OR) 1.79, 95% CI 1.26–2.56; TKA: OR 1.73, 95% CI 1.20–2.51)
The benefits of THA and TKA are well documented for pain and function, relatively little is known on their impact on one specific aspect of physical functioning, i.e. physical activity (PA)

Summary

Introduction

The numbers of patients undergoing total hip or total knee arthroplasty (THA or TKA) for hip or knee osteoarthritis (OA) are rapidly increasing. The outcomes are favourable, with a large majority of patients having less pain and improved physical functioning after surgery [1,2,3,4]. Just like for any other individual, achieving and maintaining a sufficient level of PA is important for patients with hip and knee OA with respect to their potential general health benefits. In patients who undergo THA or TKA, PA may have an additional beneficial effect on the quality of the bone, which in turn may Rheumatol Int (2017) 37:219–227 prevent complications such as early loosening [5,6,7,8]. PA may have a positive effect on muscle strength and range of motion of the affected leg [9]

Objectives

Methods

Results