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Preoperative Activity Level an Indicator of Postoperative Functional Outcomes with a Contemporary Revision Total Knee System
Journal of Knee Surgery ( IF 1.7 ) Pub Date : 2022-07-11 , DOI: 10.1055/s-0042-1749606
Richard L Auran 1 , Samuel L Ashby 2 , Kirby D Hitt 3 , David J Jacofsky 4
Affiliation  

As the population requiring revision total knee arthroplasty (rTKA) grows, varying preoperative conditions may need to be considered when attempting to predict postoperative outcomes. Considering preoperative activity levels may help manage the expectations of patients. The purpose of this study was to analyze the outcomes of low- and high-activity subgroups of patients receiving a contemporary rTKA. One hundred and eighty-one rTKA patients enrolled in a prospective multicenter study were evaluated over a minimum follow-up of 2 years postoperatively. Patients were divided into two groups based on the preoperative activity level using the Lower Extremity Activity Scale. Patients scoring between 1 and 7 were classified as “Low Activity” (LA; N = 105) and patients scoring 8 to 18 were classified as “High Activity” (HA; N = 76). Clinical outcomes were evaluated, with an additional quality-of-life analysis completed utilizing SF-6D (6-dimension short form) scores obtained through a method described by Brazier et al and analyzed for effect size. There were no significant differences in age or body mass index between the groups. Postoperative improvement in both groups were similar in the Knee Society score (KSS), but the LA group showed larger increases in the KSS functional assessment at 6 months (16.2) and 2 years (34.8). There was a statistically significant effect (0.96, p = 0.0006) seen in the LA group at 1 year, in conjunction with a higher SF-6D outcome. The current study population displayed significant improvement in functional patient outcomes following rTKA regardless of preoperative activity level and function. Patients with lower preoperative activity levels demonstrated greater cumulative functional and quality-of-life improvements. This suggests that a lower preoperative activity level may be related to a poorly functioning knee and that rTKA has the potential to improve overall activity levels and function. Low preoperative function should not disqualify patients for rTKA.



中文翻译:

术前活动水平是现代全膝关节翻修系统术后功能结果的指标

随着需要翻修全膝关节置换术 (rTKA) 的人群不断增长,在尝试预测术后结果时可能需要考虑不同的术前条件。考虑术前活动水平可能有助于管理患者的期望。本研究的目的是分析接受当代 rTKA 的低活性亚组和高活性亚组患者的结果。参加一项前瞻性多中心研究的 181 名 rTKA 患者在术后至少 2 年的随访中进行了评估。使用下肢活动量表根据术前活动水平将患者分为两组。得分在 1 到 7 之间的患者被分类为“低活动”(LA;N  = 105),得分为 8 到 18 的患者被分类为“高活动”(HA;N  = 76)。对临床结果进行了评估,并利用通过 Brazier 等人描述的方法获得的 SF-6D(6 维简式)评分完成了额外的生活质量分析,并分析了效应大小。各组之间的年龄或体重指数没有显着差异。术后两组膝关节协会评分 (KSS) 的改善相似,但 LA 组在 6 个月 (16.2) 和 2 年 (34.8) 时的 KSS 功能评估显示出更大的增加。LA 组在 1 年时观察到具有统计学意义的显着效果(0.96,p  = 0.0006),并且 SF-6D 结果较高。目前的研究人群显示,无论术前活动水平和功能如何,rTKA 后患者的功能结果均显着改善。术前活动水平较低的患者表现出更大的累积功能和生活质量改善。这表明术前较低的活动水平可能与膝关节功能不佳有关,而 rTKA 有可能改善整体活动水平和功能。术前功能低下不应使患者失去 rTKA 资格。

更新日期:2022-07-12
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