Article

Total knee arthroplasty (TKA) has been shown to be an effective
surgical intervention for people with end-stage knee osteoarthritis. However,
recovery of function is variable, and not all people have successful outcomes.
OBJECTIVE: The aim of this study was to discern which early postoperative
functional measures could predict functional ability at 1 year and 2 years after
surgery. DESIGN AND METHODS: One hundred fifty-five people who underwent
unilateral TKA participated in the prospective longitudinal study. Functional
evaluations were performed at the initial outpatient physical therapy appointment
and at 1 and 2 years after surgery. Evaluations consisted of measurements of
height, weight, quadriceps muscle strength (force-generating capacity), and knee
range of motion; the Timed "Up & Go" Test (TUG); the stair-climbing task (SCT);
and the Knee Outcome Survey (KOS) questionnaire. The ability to predict 1- and
2-year outcomes on the basis of early postoperative measures was analyzed with a
hierarchical regression. Differences in functional scores were evaluated with a
repeated-measures analysis of variance. RESULTS: The TUG, SCT, and KOS scores at
1 and 2 years showed significant improvements over the scores at the initial
evaluation (P<.001). A weaker quadriceps muscle in the limb that did not undergo
surgery ("nonoperated limb") was related to poorer 1- and 2-year outcomes even
after the influence of the other early postoperative measures was accounted for
in the regression. Older participants with higher body masses also had poorer
outcomes at 1 and 2 years. Postoperative measures were better predictors of TUG
and SCT times than of KOS scores. CONCLUSIONS: Rehabilitation regimens after TKA
should include exercises to improve the strength of the nonoperated limb as well
as to treat the deficits imposed by the surgery. Emphasis on treating age-related
impairments and reducing body mass also might improve long-term outcomes.

Langue : ANGLAIS