Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 11/2023

24.07.2023 | Knee Arthroplasty

Predictors for activity following total and unicompartmental knee arthroplasty

verfasst von: Laura E. Streck, Carola Hanreich, Agnes D. Cororaton, Cosima S. Boettner, Friedrich Boettner

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 11/2023

Einloggen, um Zugang zu erhalten

Abstract

Background

Functional demands of patients undergoing knee arthroplasty are increasing. However, it remains unclear which patient-specific factors have an impact on postoperative activity and whether there is a difference between total and unicompartmental knee arthroplasties (TKA/UKA).

Materials and methods

This retrospective study analyzed 1907 knees with TKA (n = 1746) or UKA (n = 161), implanted for primary osteoarthritis. Pain and activity (lower extremity activity scale, LEAS) were assessed 2 years after surgery. High activity was defined as LEAS ≥ 14. Cohorts were compared using Kruskal–Wallis or Pearson-Chi-square test. A generalized least squares model was used to predict LEAS scores between cohorts adjusted for age, sex, BMI, Charlson Comorbidity Index, ASA score, and preoperative LEAS.

Result

There was no difference in pain 2 years after surgery between UKA and TKA (p = 0.952). Preoperative LEAS was similar for UKA and TKA (p = 0.994), and both groups showed significant (p < 0.001 respectively) and similar improvements after surgery (p = 0.068). LEAS 2 years after surgery was 11.1 (SD 3.2) for TKA and 11.9 (SD 3.5) for the UKA group (p = 0.004). After adjusting for preoperative LEAS, age, sex, BMI, CCI and ASA, the difference was not significant (p = 0.225). Male sex, lower BMI, higher preoperative LEAS, and younger age were associated with higher postoperative LEAS (p < 0.001, respectively).

Conclusion

Patients can achieve a high level of activity following both TKA and UKA. While the postoperative activity level did not depend on the type of the procedure, younger age, male sex, lower BMI, and a higher preoperative activity level were associated with a higher postoperative activity level.
Literatur
1.
Zurück zum Zitat Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet (London, England) 2016;388:1545–602. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet (London, England) 2016;388:1545–602.
2.
Zurück zum Zitat Waldstein W, Kolbitsch P, Koller U, Boettner F, Windhager R (2017) Sport and physical activity following unicompartmental knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 25:717–728CrossRef Waldstein W, Kolbitsch P, Koller U, Boettner F, Windhager R (2017) Sport and physical activity following unicompartmental knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 25:717–728CrossRef
3.
Zurück zum Zitat Kleeblad LJ, van der List JP, Zuiderbaan HA, Pearle AD (2018) Larger range of motion and increased return to activity, but higher revision rates following unicompartmental versus total knee arthroplasty in patients under 65: a systematic review. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 26:1811–1822CrossRef Kleeblad LJ, van der List JP, Zuiderbaan HA, Pearle AD (2018) Larger range of motion and increased return to activity, but higher revision rates following unicompartmental versus total knee arthroplasty in patients under 65: a systematic review. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 26:1811–1822CrossRef
4.
Zurück zum Zitat Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ (2010) Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 468:57–63CrossRefPubMed Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ (2010) Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 468:57–63CrossRefPubMed
5.
Zurück zum Zitat Beard DJ, Davies LJ, Cook JA, MacLennan G, Price A, Kent S et al (2020) Total versus partial knee replacement in patients with medial compartment knee osteoarthritis: the TOPKAT RCT. Health Technol Assess (Winchester, England) 24:1–98CrossRef Beard DJ, Davies LJ, Cook JA, MacLennan G, Price A, Kent S et al (2020) Total versus partial knee replacement in patients with medial compartment knee osteoarthritis: the TOPKAT RCT. Health Technol Assess (Winchester, England) 24:1–98CrossRef
6.
Zurück zum Zitat Kleeblad LJ, Strickland SM, Nwachukwu BU, Kerkhoffs GMMJ, Pearle AD (2020) Satisfaction with return to sports after unicompartmental knee arthroplasty and what type of sports are patients doing. Knee 27:509–517CrossRefPubMed Kleeblad LJ, Strickland SM, Nwachukwu BU, Kerkhoffs GMMJ, Pearle AD (2020) Satisfaction with return to sports after unicompartmental knee arthroplasty and what type of sports are patients doing. Knee 27:509–517CrossRefPubMed
7.
Zurück zum Zitat Hanreich C, Martelanz L, Koller U, Windhager R, Waldstein W (2020) Sport and physical activity following primary total knee arthroplasty: a systematic review and meta-analysis. J Arthroplast 35:2274-2285.e1CrossRef Hanreich C, Martelanz L, Koller U, Windhager R, Waldstein W (2020) Sport and physical activity following primary total knee arthroplasty: a systematic review and meta-analysis. J Arthroplast 35:2274-2285.e1CrossRef
8.
Zurück zum Zitat Deshmukh RV, Scott RD (2002) Unicompartmental knee arthroplasty for younger patients: an alternative view. Clin Orthop Related Res 404:108–112CrossRef Deshmukh RV, Scott RD (2002) Unicompartmental knee arthroplasty for younger patients: an alternative view. Clin Orthop Related Res 404:108–112CrossRef
9.
Zurück zum Zitat Witjes S, van Geenen RCI, Koenraadt KLM, van der Hart CP, Blankevoort L, Kerkhoffs GMMJ et al (2017) Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions? Qual Life Res Int J Qual Life Asp Treat Care Rehabil 26:403–417CrossRef Witjes S, van Geenen RCI, Koenraadt KLM, van der Hart CP, Blankevoort L, Kerkhoffs GMMJ et al (2017) Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions? Qual Life Res Int J Qual Life Asp Treat Care Rehabil 26:403–417CrossRef
10.
Zurück zum Zitat Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res 467:2606–2612CrossRefPubMedPubMedCentral Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res 467:2606–2612CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Biswas D, van Thiel GS, Wetters NG, Pack BJ, Berger RA, Della Valle CJ (2014) Medial unicompartmental knee arthroplasty in patients less than 55 years old: minimum of two years of follow-up. J Arthroplast 29:101–105CrossRef Biswas D, van Thiel GS, Wetters NG, Pack BJ, Berger RA, Della Valle CJ (2014) Medial unicompartmental knee arthroplasty in patients less than 55 years old: minimum of two years of follow-up. J Arthroplast 29:101–105CrossRef
12.
13.
Zurück zum Zitat Murray DW, Liddle AD, Dodd CAF, Pandit H (2015) Unicompartmental knee arthroplasty: is the glass half full or half empty? Bone Joint J 97-B:3–8CrossRefPubMedPubMedCentral Murray DW, Liddle AD, Dodd CAF, Pandit H (2015) Unicompartmental knee arthroplasty: is the glass half full or half empty? Bone Joint J 97-B:3–8CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br 73:582–586CrossRefPubMed White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. J Bone Joint Surg Br 73:582–586CrossRefPubMed
15.
Zurück zum Zitat Deschamps G, Chol C (2011) Fixed-bearing unicompartmental knee arthroplasty. Patients’ selection and operative technique. Orthop Traumatol Surg Res OTSR 97:648–661CrossRefPubMed Deschamps G, Chol C (2011) Fixed-bearing unicompartmental knee arthroplasty. Patients’ selection and operative technique. Orthop Traumatol Surg Res OTSR 97:648–661CrossRefPubMed
16.
Zurück zum Zitat Sanchez-Santos MT, Garriga C, Judge A, Batra RN, Price AJ, Liddle AD et al (2018) Development and validation of a clinical prediction model for patient-reported pain and function after primary total knee replacement surgery. Sci Rep 8:3381CrossRefPubMedPubMedCentral Sanchez-Santos MT, Garriga C, Judge A, Batra RN, Price AJ, Liddle AD et al (2018) Development and validation of a clinical prediction model for patient-reported pain and function after primary total knee replacement surgery. Sci Rep 8:3381CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Weber M, Craiovan B, Woerner ML, Schwarz T, Grifka J, Renkawitz TF (2018) Predictors of outcome after primary total joint replacement. J Arthroplasty 33:431–435CrossRefPubMed Weber M, Craiovan B, Woerner ML, Schwarz T, Grifka J, Renkawitz TF (2018) Predictors of outcome after primary total joint replacement. J Arthroplasty 33:431–435CrossRefPubMed
18.
Zurück zum Zitat Pua Y-H, Poon CL-L, Seah FJ-T, Thumboo J, Clark RA, Tan M-H et al (2019) Predicting individual knee range of motion, knee pain, and walking limitation outcomes following total knee arthroplasty. Acta Orthop 90:179–186CrossRefPubMedPubMedCentral Pua Y-H, Poon CL-L, Seah FJ-T, Thumboo J, Clark RA, Tan M-H et al (2019) Predicting individual knee range of motion, knee pain, and walking limitation outcomes following total knee arthroplasty. Acta Orthop 90:179–186CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Deshmukh RV, Scott RD (2001) Unicompartmental knee arthroplasty: long-term results. Clin Orthop Relat Res 392:272–278CrossRef Deshmukh RV, Scott RD (2001) Unicompartmental knee arthroplasty: long-term results. Clin Orthop Relat Res 392:272–278CrossRef
20.
Zurück zum Zitat Saleh KJ, Mulhall KJ, Bershadsky B, Ghomrawi HM, White LE, Buyea CM et al (2005) Development and validation of a lower-extremity activity scale. Use for patients treated with revision total knee arthroplasty. J Bone Joint Surg Am 87:1985–1994CrossRefPubMed Saleh KJ, Mulhall KJ, Bershadsky B, Ghomrawi HM, White LE, Buyea CM et al (2005) Development and validation of a lower-extremity activity scale. Use for patients treated with revision total knee arthroplasty. J Bone Joint Surg Am 87:1985–1994CrossRefPubMed
22.
Zurück zum Zitat Witjes S, Gouttebarge V, Kuijer PPFM, van Geenen RCI, Poolman RW, Kerkhoffs GMMJ (2016) Return to sports and physical activity after total and unicondylar knee arthroplasty: a systematic review and meta-analysis. Sports Med (Auckland, N.Z.) 46:269–292CrossRef Witjes S, Gouttebarge V, Kuijer PPFM, van Geenen RCI, Poolman RW, Kerkhoffs GMMJ (2016) Return to sports and physical activity after total and unicondylar knee arthroplasty: a systematic review and meta-analysis. Sports Med (Auckland, N.Z.) 46:269–292CrossRef
23.
Zurück zum Zitat Wilson HA, Middleton R, Abram SGF, Smith S, Alvand A, Jackson WF et al (2019) Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis. BMJ (Clinical research ed) 364:l352PubMed Wilson HA, Middleton R, Abram SGF, Smith S, Alvand A, Jackson WF et al (2019) Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis. BMJ (Clinical research ed) 364:l352PubMed
24.
Zurück zum Zitat Knifsund J, Niinimaki T, Nurmi H, Toom A, Keemu H, Laaksonen I et al (2021) Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty: two-year results of a randomised, assessor-blinded multicentre trial. BMJ Open 11:e046731CrossRefPubMedPubMedCentral Knifsund J, Niinimaki T, Nurmi H, Toom A, Keemu H, Laaksonen I et al (2021) Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty: two-year results of a randomised, assessor-blinded multicentre trial. BMJ Open 11:e046731CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Sershon RA, Fricka KB, Hamilton WG, Nam D, Parks NL, DeBenedetti A et al (2022) Early results of a randomized controlled trial of partial versus total knee arthroplasty. J Arthroplast 37:S94–S97CrossRef Sershon RA, Fricka KB, Hamilton WG, Nam D, Parks NL, DeBenedetti A et al (2022) Early results of a randomized controlled trial of partial versus total knee arthroplasty. J Arthroplast 37:S94–S97CrossRef
26.
Zurück zum Zitat Williams DH, Greidanus NV, Masri BA, Duncan CP, Garbuz DS (2012) Predictors of participation in sports after hip and knee arthroplasty. Clin Orthop Relat Res 470:555–561CrossRefPubMed Williams DH, Greidanus NV, Masri BA, Duncan CP, Garbuz DS (2012) Predictors of participation in sports after hip and knee arthroplasty. Clin Orthop Relat Res 470:555–561CrossRefPubMed
27.
Zurück zum Zitat Harbourne AD, Sanchez-Santos MT, Arden NK, Filbay SR (2019) Predictors of return to desired activity 12 months following unicompartmental and total knee arthroplasty. Acta Orthop 90:74–80CrossRefPubMed Harbourne AD, Sanchez-Santos MT, Arden NK, Filbay SR (2019) Predictors of return to desired activity 12 months following unicompartmental and total knee arthroplasty. Acta Orthop 90:74–80CrossRefPubMed
28.
Zurück zum Zitat Da Rocha SR, Filardi De Oliveira P, Almeida MM (2018) Sports activity after total knee arthroplasty. Ortop Traumatol Rehabil 20:133–138CrossRef Da Rocha SR, Filardi De Oliveira P, Almeida MM (2018) Sports activity after total knee arthroplasty. Ortop Traumatol Rehabil 20:133–138CrossRef
30.
Zurück zum Zitat D’Ambrosi R, Nuara A, Mariani I, Corona K, Mogos S, Catellani F et al (2021) Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty. J Orthop Traumatol Off J Italian Soc Orthop Traumatol 22:36CrossRef D’Ambrosi R, Nuara A, Mariani I, Corona K, Mogos S, Catellani F et al (2021) Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty. J Orthop Traumatol Off J Italian Soc Orthop Traumatol 22:36CrossRef
31.
Zurück zum Zitat Coelho A, Leal-Blanquet J, Sánchez-Soler JF, Torres-Claramunt R, Hinarejos P, Monllau JC (2022) Patients lose weight after a total knee arthroplasty: myth or reality? Int Orthop 46:1299–1304CrossRefPubMed Coelho A, Leal-Blanquet J, Sánchez-Soler JF, Torres-Claramunt R, Hinarejos P, Monllau JC (2022) Patients lose weight after a total knee arthroplasty: myth or reality? Int Orthop 46:1299–1304CrossRefPubMed
32.
Zurück zum Zitat Smith WA, Zucker-Levin A, Mihalko WM, Williams M, Loftin M, Gurney JG (2017) Physical function and physical activity in obese adults after total knee arthroplasty. Orthop Clin North Am 48:117–125CrossRefPubMed Smith WA, Zucker-Levin A, Mihalko WM, Williams M, Loftin M, Gurney JG (2017) Physical function and physical activity in obese adults after total knee arthroplasty. Orthop Clin North Am 48:117–125CrossRefPubMed
Metadaten
Titel
Predictors for activity following total and unicompartmental knee arthroplasty
verfasst von
Laura E. Streck
Carola Hanreich
Agnes D. Cororaton
Cosima S. Boettner
Friedrich Boettner
Publikationsdatum
24.07.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 11/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-023-04973-0

Weitere Artikel der Ausgabe 11/2023

Archives of Orthopaedic and Trauma Surgery 11/2023 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.