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Correlation of quality of life with instrumented analysis of a total knee arthroplasty series at the long-term follow-up

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The relationship between instrumented knee measurements and patient-reported outcome measures is a newer field that continues to evolve. The aim of this study was to evaluate long-term quality of life (QoL) post-total knee arthroplasty (TKA) surgery correlating validated self-reported questionnaires, clinical examination and instrumented analysis, using baropodometry and accelerometry.

Methods

Thirty-six patients who underwent primary unilateral TKA between 1999 and 2006 were evaluated at 11.3 ± 2.3 years following surgery. Clinical examination included range of motion (ROM) and instrumented knee laxity measurements with the Rolimeter device. The visual analogue scale (VAS) for pain was also recorded. The utilised subjective outcome scores were the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form of World Health Organisation Quality of Life (WHOQOL-BREF). Instrumented analysis was performed with baropodometry and accelerometry. QoL was assessed correlating clinical, subjective and instrumented results. Univariate analysis included the Spearman’s Rho correlation coefficient and Mann–Whitney tests.

Results

At the long-term follow-up all patients had relatively high quality of life measurements, as well as functional scores, except for the Sport/Rec dimension of the KOOS score. Only cadence (p = 0.008) and velocity (p = 0.026) affected the WHOQOL psychology domain no matter the age, follow-up and gender of the patients. The domain was unaffected by VAS and Rolimeter measurements. WHOQOL Social domain was unaffected by all instrumentation measurements except for stance phase (p = 0.025), VAS (p = 0.005) and ROM (p = 0.028). KOOS physical domain was not affected by any parameter. KOOS pain was reversely affected by VAS (p = 0.004), KOOS symptom by ROM (p = 0.000 and median maximum pressure (p = 0.033).

Conclusion

Quality of life for the TKA patient can be correlated and assessed reliably with instrumented analysis using pedobarography and accelerometry, at the long-term follow-up.

Level of evidence

III

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References

  1. White DK, Master H (2016) Patient-reported measures of physical function in knee osteoarthritis. Rheum Dis Clin North Am 42:239–252. https://doi.org/10.1016/j.rdc.2016.01.005

    Article  PubMed  PubMed Central  Google Scholar 

  2. da Silva RR, Santos AA, de Junior JSC, Matos MA (2014) Quality of life after total knee arthroplasty: systematic review. Rev Bras Ortop 49:520–527. https://doi.org/10.1016/j.rboe.2014.09.007

    Article  PubMed  PubMed Central  Google Scholar 

  3. Deirmengian CA, Lonner JH (2013) What’s new in adult reconstructive knee surgery. J Bone Joint Surg Am 95:184–190. https://doi.org/10.2106/JBJS.L.01050

    Article  PubMed  Google Scholar 

  4. Ellis HB, Howard KJ, Khaleel MA, Bucholz R (2012) Effect of psychopathology on patient-perceived outcomes of total knee arthroplasty within an indigent population. J Bone Jt Surgery, Am 94:e84. https://doi.org/10.2106/jbjs.k.00888

    Article  Google Scholar 

  5. Mahler E, Cuperus N, Bijlsma J et al (2016) Responsiveness of four patient-reported outcome measures to assess physical function in patients with knee osteoarthritis. Scand J Rheumatol 9742:1–10. https://doi.org/10.3109/03009742.2016.1140226

    Article  CAS  Google Scholar 

  6. Rodriguez-Merchan EC (2012) Knee instruments and rating scales designed to measure outcomes. J Orthop Traumatol 13:1–6. https://doi.org/10.1007/s10195-011-0177-4

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kappel A, Laursen M, Nielsen PT, Odgaard A (2019) Relationship between outcome scores and knee laxity following total knee arthroplasty: a systematic review. Acta Orthop 90:46–52. https://doi.org/10.1080/17453674.2018.1554400

    Article  PubMed  Google Scholar 

  8. Notarnicola A, Maccagnano G, Fiore A et al (2018) Baropodometry on patients after total knee arthroplasty. Musculoskelet Surg 102:129–137. https://doi.org/10.1007/s12306-017-0505-9

    Article  CAS  PubMed  Google Scholar 

  9. Soeno T, Mochizuki T, Tanifuji O et al (2018) No differences in objective dynamic instability during acceleration of the knee with or without subjective instability post-total knee arthroplasty. PLoS ONE 13:e0194221. https://doi.org/10.1371/journal.pone.0194221

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Bakirhan S, Angin S, Karatosun V et al (2009) A comparison of static and dynamic balance in patients with unilateral and bilateral total knee arthroplasty. Eklem Hastalik Cerrahisi 20:93–101

    PubMed  Google Scholar 

  11. Small SR, Bullock GS, Khalid S et al (2019) Current clinical utilisation of wearable motion sensors for the assessment of outcome following knee arthroplasty: a scoping review. BMJ Open 9:e033832. https://doi.org/10.1136/bmjopen-2019-033832

    Article  PubMed  PubMed Central  Google Scholar 

  12. Youn I-H, Youn J-H, Zeni JA, Knarr BA (2018) Biomechanical gait variable estimation using wearable sensors after unilateral total knee arthroplasty. Sens (Basel). https://doi.org/10.3390/s18051577

    Article  Google Scholar 

  13. Chiang C-Y, Chen K-H, Liu K-C et al (2017) Data collection and analysis using wearable sensors for monitoring knee range of motion after total knee arthroplasty. Sens (Basel). https://doi.org/10.3390/s17020418

    Article  Google Scholar 

  14. Mochizuki T, Tanifuji O, Sato T et al (2017) Association between anteroposterior laxity in mid-range flexion and subjective healing of instability after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25:3543–3548. https://doi.org/10.1007/s00167-016-4375-8

    Article  PubMed  Google Scholar 

  15. Victor J (2017) Optimising position and stability in total knee arthroplasty. EFORT open Rev 2:215–220. https://doi.org/10.1302/2058-5241.2.170001

    Article  PubMed  PubMed Central  Google Scholar 

  16. Collins NJ, Prinsen CAC, Christensen R et al (2016) Knee injury and osteoarthritis outcome score (KOOS): systematic review and meta-analysis of measurement properties. Osteoarthr Cartil. https://doi.org/10.1016/j.joca.2016.03.010

    Article  Google Scholar 

  17. Peer M, Lane JV (2013) The knee injury and osteoarthritis outcome score (KOOS): a review of its psychometric properties in people undergoing total knee arthroplasty. J Orthop Sports Phys Ther 43:20–28. https://doi.org/10.2519/jospt.2013.4057

    Article  PubMed  Google Scholar 

  18. Pugh L, Mascarenhas R, Arneja S et al (2008) Current concepts in instrumented knee-laxity testing. Am J Sports Med 37:199–210. https://doi.org/10.1177/0363546508323746

    Article  PubMed  Google Scholar 

  19. Schuster AJ, McNicholas MJ, Wachtl SW et al (2004) A new mechanical testing device for measuring anteroposterior knee laxity. Am J Sports Med 32:1731–1735. https://doi.org/10.1177/0363546504267050

    Article  PubMed  Google Scholar 

  20. Balasch H, Schiller M, Friebel H, Hoffmann F (1999) Evaluation of anterior knee joint instability with the Rolimeter. A test in comparison with manual assessment and measuring with the KT-1000 arthrometer. Knee Surg Sports Traumatol Arthrosc 7:204–208

    Article  CAS  Google Scholar 

  21. WHOQOL Group (1998) Development of the world health organization WHOQOL-BREF quality of life assessment. Psychol Med 28:551–8

    Article  Google Scholar 

  22. Skevington SM, Lotfy M, O’Connell KA, WHOQOL Group (2004) The world health organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 13:299–310

    Article  CAS  Google Scholar 

  23. Farrahi V, Niemelä M, Kangas M et al (2019) Calibration and validation of accelerometer-based activity monitors: a systematic review of machine-learning approaches. Gait Posture 68:285–299. https://doi.org/10.1016/j.gaitpost.2018.12.003

    Article  PubMed  Google Scholar 

  24. Melchiorri G, Viero V, Triossi T et al (2020) Use of the pedometer in the evaluation of the effects of rehabilitation treatment on deambulatory autonomy in patients with lower limb arthroplasty during hospital rehabilitation: long-term postoperative outcomes. J Phys Ther Sci 32:243–250. https://doi.org/10.1589/jpts.32.243

    Article  PubMed  PubMed Central  Google Scholar 

  25. Paxton RJ, Melanson EL, Stevens-Lapsley JE, Christiansen CL (2015) Physical activity after total knee arthroplasty: a critical review. World J Orthop 6:614–622. https://doi.org/10.5312/wjo.v6.i8.614

    Article  PubMed  PubMed Central  Google Scholar 

  26. Frimpong E, McVeigh JA, Meiring RM (2018) Sedentary behavior in patients with knee osteoarthritis before and after total knee arthroplasty: a systematic review. J Aging Phys Act 26:671–681. https://doi.org/10.1123/japa.2017-0214

    Article  PubMed  Google Scholar 

  27. Harris TJ, Owen CG, Victor CR et al (2009) A comparison of questionnaire, accelerometer, and pedometer: measures in older people. Med Sci Sports Exerc 41:1392–1402. https://doi.org/10.1249/MSS.0b013e31819b3533

    Article  PubMed  Google Scholar 

  28. Marsico V, Moretti B, Patella V et al (2002) Baropodometric walking analysis in healthy elderly and in arthritic patients before and after knee prosthesis implantation. G Ital Med Lav Ergon 24:72–83

    CAS  PubMed  Google Scholar 

  29. Bergami E, Gildone A, Zanoli G et al (2005) Static and dynamic baropodometry to evaluate patients treated by total knee replacement with a mobile meniscus. Chir Organi Mov 90:387–396

    CAS  PubMed  Google Scholar 

  30. Schuster AJ, von Roll AL, Pfluger D, Wyss T (2011) Anteroposterior stability after posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19:1113–1120. https://doi.org/10.1007/s00167-010-1364-1

    Article  CAS  PubMed  Google Scholar 

  31. van Hal CTH, van Hellemondt GG, Wymenga AB, Jacobs WCH (2007) The anterior-posterior laxity after total knee arthroplasty inserted with a ligament tensor. Knee Surg Sports Traumatol Arthrosc 15:1019–1022. https://doi.org/10.1007/s00167-007-0333-9

    Article  PubMed  Google Scholar 

  32. Papagiannis GI, Triantafyllou AI, Roumpelakis IM et al (2018) Gait analysis methodology for the measurement of biomechanical parameters in total knee arthroplasties. A literature review J Orthop 15:181–185. https://doi.org/10.1016/j.jor.2018.01.048

    Article  PubMed  Google Scholar 

  33. Meiring RM, Frimpong E, Mokete L et al (2016) Rationale, design and protocol of a longitudinal study assessing the effect of total knee arthroplasty on habitual physical activity and sedentary behavior in adults with osteoarthritis. BMC Musculoskelet Disord 17:281. https://doi.org/10.1186/s12891-016-1141-5

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The authors did not receive support from any organisation for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Trauma and Orthopaedics, Patras University Hospital, Patras, Greece

    Elias Panagiotopoulos

  2. Department of Rehabilitation, Patras University Hospital, Patras, Greece

    Theodoros Bouras, Ioannis-Alexandros Tzanos & Elias Panagiotopoulos

  3. Physical Medicine and Rehabilitation Department, “KAT” General Hospital, Athens, Greece

    Ioannis-Alexandros Tzanos

  4. Department of Trauma and Orthopaedics, Cardiff and Vale UHB, University Hospital Llandough, Llandough, Wales, UK

    Theodoros Bouras & Mark Forster

Authors
  1. Theodoros Bouras
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  2. Ioannis-Alexandros Tzanos
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  3. Mark Forster
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  4. Elias Panagiotopoulos
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Contributions

TB conceived of the study and participated in its design, collected the data and drafted the manuscript. I-AT participated in the design of the study and helped to draft the manuscript. MF helped to draft the manuscript. EP conceived of the study and participated in its design and coordination. All authors read and approved the final manuscript.

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Correspondence to Theodoros Bouras.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all patients.

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Bouras, T., Tzanos, IA., Forster, M. et al. Correlation of quality of life with instrumented analysis of a total knee arthroplasty series at the long-term follow-up. Eur J Orthop Surg Traumatol 31, 1171–1177 (2021). https://doi.org/10.1007/s00590-020-02867-0

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  • DOI: https://doi.org/10.1007/s00590-020-02867-0

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