Ann Geriatr Med Res.  2020 Jun;24(2):99-106. 10.4235/agmr.20.0018.

Physical Performance Correlates with Self-Reported Physical Function and Quality of Life in Patients at 3 Months after Total Knee Arthroplasty

• Choi JH
• Kim BR
• Kim SR
• Nam KW
• Lee SY
• Kim WB
• Kim YJ

• KMID: 2503335
• DOI: http://doi.org/10.4235/agmr.20.0018

Abstract

Background
Although total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis, assessment of postoperative outcomes remains unclear. This study aimed to identify postoperative physical performance factors that are predictive of self-reported physical function and quality of life (QoL) at 3 months after unilateral TKA.
Methods
In total, 158 patients who underwent unilateral primary TKA completed performance-based physical function tests at 3 months after surgery, including Stair Climbing Tests (SCT), 6-Minute Walk Tests (6MWT), Timed Up and Go tests (TUG), and instrumental gait analysis. We also measured the isometric knee flexor and extensor strengths of the operated and non-operated knees. Self-reported physical function and QoL were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Euro-QoL Five Dimensions (EQ-5D) questionnaire, respectively.
Results
Bivariate analyses showed that WOMAC function and EQ-5D were correlated with age, other self-reported measures, and performance-based measures. The WOMAC pain (r=0.71, p<0.001) showed a high positive correlation. While the EQ-5D (r=-0.7, p<0.001) showed a highly negative correlation with WOMAC function, WOMAC pain (r=-0.67, p<0.001) showed a moderately negative correlation with EQ-5D. In multivariate linear regression analyses, WOMAC pain, peak torque of the flexor of the non-operated knee, and reductions in extensor and stride length were predictive of postoperative WOMAC function, whereas WOMAC pain, SCT ascent, and cadence were predictive of postoperative EQ-5D.
Conclusions
Physical performance factors were significantly associated with self-reported physical function and QoL in patients at 3 months after unilateral TKA. These findings suggest that performance-based physical function could be used to assess outcomes after TKA.

Keyword

Osteoarthritis; Knee; Arthroplasty; Rehabilitation; Quality of life