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Predictors for activity following total and unicompartmental knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

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Data availability

The data that support the findings of this study are available at Hospital for Special Surgery. Restrictions apply to the availability of these data.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA

    Laura E. Streck, Carola Hanreich, Cosima S. Boettner & Friedrich Boettner

  2. Department of Visceral Surgery, University Hospital Bern, Freiburgerstrasse, 3010, Bern, Switzerland

    Carola Hanreich

  3. Biostatistics Core, Research Administration, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA

    Agnes D. Cororaton

Authors
  1. Laura E. Streck
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  2. Carola Hanreich
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  3. Agnes D. Cororaton
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  4. Cosima S. Boettner
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  5. Friedrich Boettner
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by LES, CH, ADC, and CFB. Supervision was done by FB. The first draft of the manuscript was written by LES and all authors commented on all versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Friedrich Boettner.

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Conflict of interest

FB reports royalties from Smith & Nephew, consultant fees, and royalties from Ortho Development Corporation and stock options in AccuJoint. This did not affect the current work. LS, CH, AC, and CB declare that they have no financial or non-financial interests to disclose.

Ethical approval

The study was approved by the author’s institutional review board. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Streck, L.E., Hanreich, C., Cororaton, A.D. et al. Predictors for activity following total and unicompartmental knee arthroplasty. Arch Orthop Trauma Surg 143, 6815–6820 (2023). https://doi.org/10.1007/s00402-023-04973-0

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  • DOI: https://doi.org/10.1007/s00402-023-04973-0

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