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A relevant number of patients do not increase their engagement in physical, social and leisure activities at the medium-term after total knee arthroplasty: a prospective cohort study

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to investigate the changes in engagement in physical, leisure and social activities in older adults following primary TKA.

Methods

A prospective study of 106 patients with a mean age of 72.6 (SD 7.4) years undergoing primary TKA was performed. Physical, social and leisure activities performed by the patients preoperatively and postoperatively at 3-year were recorded. Activities were selected according to the age, and grouped as passive, moderate and high intensity. The energy spent in each activity was expressed in Metabolic Equivalent of Task (MET) units. Charlson Comorbidity Index, Mini-mental test and Western Ontario and McMaster Universities (WOMAC) scores were also used. Multivariate analysis was used to identify predictors of active patients.

Results

Mean WOMAC significantly improved from preoperative (34.8, SD 11.8) to final follow-up (74.4, SD 11.1) (p = 0.001), and the mean energy spent increased from 10.7 (SD 13.6) to 28.2 (SD 16.2) MET-hour weekly (p = 0.001) with a decrease in the passive activities and increase in the moderate activities. However, the participation in high-intensity activities according to age was negligible. Only 65 (61.3%) patients were considered active postoperatively (weekly spending ≥ 40 MET), although the WOMAC scores were not significantly different between active and sedentary patients. Active patients compared with sedentary patients had a significant increase in engagement in physical, social and leisure activities, and a decrease in passive activities. Female gender (p = 0.037), less preoperatively participation in passive activities (p = 0.042), and greater participation in social activities (p = 0.027) were significant predictors of active patients at the final follow-up.

Conclusion

Overall, most patients increased their activity level postoperatively. However, 38.6% of patients had no increased engagement in moderate physical, social or leisure activities at the medium-term despite improvements in pain and function provided by TKA.

Level of evidence

II.

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Funding

There was no funding for this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax s/n, Elda, 03600, Alicante, Spain

    Marta Rubio-Morales, Francisco A. Miralles-Muñoz, Santiago Gonzalez-Parreño, Matias Ruiz-Lozano & Alejandro Lizaur-Utrilla

  2. Department of Traumatology and Orthopaedics, Miguel Hernandez University, Avda Universidad s/n, San Juan de Alicante, 03202, Alicante, Spain

    Santiago Gonzalez-Parreño & Alejandro Lizaur-Utrilla

  3. Unit of Clinical Nursing Research, Faculty of Health Sciences, University of Alicante, Ctra S Vicente Raspeig s/n, 06390, Alicante, Spain

    M. Flores Vizcaya-Moreno

Authors
  1. Marta Rubio-Morales
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  2. Francisco A. Miralles-Muñoz
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  3. Santiago Gonzalez-Parreño
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  4. Matias Ruiz-Lozano
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  5. Alejandro Lizaur-Utrilla
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Correspondence to Alejandro Lizaur-Utrilla.

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The present study was approved by the Ethics Committee and informed consent was required.

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Rubio-Morales, M., Miralles-Muñoz, F.A., Gonzalez-Parreño, S. et al. A relevant number of patients do not increase their engagement in physical, social and leisure activities at the medium-term after total knee arthroplasty: a prospective cohort study. Knee Surg Sports Traumatol Arthrosc 31, 1011–1017 (2023). https://doi.org/10.1007/s00167-022-07165-2

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