Article

OBJECTIVE: To characterize patient outcomes after total knee arthroplasty (TKA)
by (1) examining changes in self-report measures (Knee Injury and Osteoarthritis
Outcome Score [KOOS]) and performance measures over the first 6 months after TKA,
(2) evaluating correlations between changes in KOOS self-report function
(activities of daily living [ADL] subscale) and functional performance (6-minute
walk [6MW]), and (3) exploring how changes in pain correlate with KOOS ADL and
6MW outcomes. DESIGN: Retrospective cohort evaluation. SETTING: Clinical research
laboratory. PATIENTS (OR PARTICIPANTS): Thirty-nine patients scheduled for a
unilateral, primary TKA for end-stage unilateral knee osteoarthritis. METHODS:
Patients were evaluated 2 weeks before surgery and 1, 3, and 6 months after
surgery. MAIN OUTCOME MEASUREMENTS: KOOS, 6MW, timed-up-and-go (TUG), and stair
climbing tests (SCT), quadriceps strength. RESULTS: Three of 5 KOOS subscales
significantly improved by 1 month after TKA. All 5 KOOS subscales significantly
improved by 3 and 6 months after TKA. In contrast, performance measures (6MW,
TUG, SCT, and quadriceps strength) all significantly declined from preoperative
values by 1 month after TKA and significantly improved from preoperative values
by 3 and 6 months after TKA; yet, improvements from preoperative values were not
clinically meaningful. Pearson correlations between changes in the KOOS ADL
subscale and 6MW from before surgery were not statistically significant at 1, 3,
or 6 months after TKA. In addition, KOOS Pain was strongly correlated with KOOS
ADL scores at all times, but KOOS Pain was not correlated with 6MW distance at
any time. CONCLUSIONS: Patient self-report by using the KOOS did not reflect the
magnitude of performance deficits present after surgery, especially 1 month after
TKA. Self-report KOOS outcomes closely paralleled pain relief after surgery,
whereas performance measures were not correlated with pain. These results
emphasize the importance of including performance measures when tracking recovery
after TKA as opposed to solely relying on self-reported measures.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS