Elsevier

The Journal of Arthroplasty

Volume 30, Issue 9, September 2015, Pages 1521-1525
The Journal of Arthroplasty

Does Total Knee Arthroplasty Affect Physical Activity Levels? Data from the Osteoarthritis Initiative

https://doi.org/10.1016/j.arth.2015.03.016Get rights and content

Abstract

Total knee arthroplasty (TKA) is associated with improved patient-reported pain levels, function, and quality of life; however, it is poorly understood whether there is increased physical activity following TKA. Using data from the Osteoarthritis Initiative (OAI), we compare physical activity, as measured using an accelerometer, and patient-reported outcome measures of 60 patients who had already received a TKA with 63 patients who eventually received a TKA during the OAI study. There was no significant difference in activity levels between the two groups as measured by the accelerometer. Total WOMAC, KOOS Quality of Life, KOOS Knee Pain, and KOOS Function scores improved in the post-TKA compared to the pre-TKA group. In both pre-TKA and post-TKA groups, physical activity guidelines were met in only 5% or less.

Section snippets

Methods

All data were obtained from the Osteoarthritis Initiative (OAI) database. The OAI is a publicly and privately funded prospective longitudinal observational study that studies the natural progression of osteoarthritis in patients [29]. The 4796 patients included in the OAI study were divided into subcohorts at the beginning of the study, which included a progression subcohort of 1389 patients who had clinically significant osteoarthritis at baseline, an incidence subcohort of 3285 patients who

Results

Based on our inclusion and exclusion criteria, there were 63 patients included in the pre-TKA group and 60 patients in the post-TKA group. Baseline characteristics of each of these groups can be seen in Table 1. The mean age of patients in pre-TKA and post-TKA groups was 68.4 (SD: 8.2) and 67.3 (SD: 8.7), respectively. The mean BMI in pre-TKA and post-TKA groups was 29.2 (SD: 4.8) and 31.1 (SD: 5.3), respectively. For the pre-TKA group, 34.9% of patients had at least 1 medical comorbidity,

Discussion

While post-TKA patients’ self-reported symptoms of knee pain, knee function, and overall quality of life were substantially better than those of the pre-TKA patients, there was no significant difference in objective measures of physical activity, as demonstrated with the accelerometry data, between pre-TKA and post-TKA patients. Of note, our data do not necessarily indicate that there is no improvement in accelerometry data following TKA, as our study observed different patients at the same

Conclusion

While TKA is associated with significantly improved patient-reported pain, function, and health-related quality of life, our study showed no significant difference in physical activity between patients who would eventually receive TKA and those who had already received TKA. Very few patients (5% or less) in either study group were currently meeting DHHS guidelines for physical activity. This suggests that despite patients’ perceived improvement in function and pain, physical activity does not

Acknowledgement

The OAI is a public–private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Merck Research Laboratories; Novartis Pharmaceuticals Corporation, GlaxoSmithKline; and Pfizer, Inc. Private sector funding for the OAI is managed by the Foundation for the

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    One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2015.03.016.

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