Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2024; 15(7): 608-617
Published online Jul 18, 2024. doi: 10.5312/wjo.v15.i7.608
Eight of ten patients return to daily activities, work, and sports after total knee arthroplasty
Maud Cornelia Wilhelmina Maria Peters, Yvette Pronk, Justus-Martijn Brinkman
Maud Cornelia Wilhelmina Maria Peters, Yvette Pronk, Department of Research, Kliniek ViaSana, Mill 5451 AA, Netherlands
Justus-Martijn Brinkman, Department of Orthopedic Surgery, Kliniek ViaSana, Mill 5451 AA, Netherlands
Author contributions: Peters MCWM, Pronk Y, and Brinkman JM designed the research study; Peters MCWM performed the research, analyzed the data, and drafted the manuscript; Pronk Y and Brinkman JM critically read and revised the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: The institutional review board declares, after having reviewed the retrospective study (study ID: 2022-6) by the Department of Orthopaedic Surgery, that this study can safely be performed in Kliniek ViaSana, without any special recommendations required.
Informed consent statement: All study participants provided informed written consent for the use of anonymized data for scientific analysis prior to undergoing primary total knee arthroplasty.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at m.peters@viasana.nl upon reasonable request. Participants did not give informed consent for data sharing, but the presented data are anonymized and risk of identification is low.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maud Cornelia Wilhelmina Maria Peters, MSc, Researcher, Department of Research, Kliniek ViaSana, Hoogveldseweg 1, Mill 5451 AA, Netherlands. m.peters@viasana.nl
Received: March 21, 2024
Revised: May 13, 2024
Accepted: May 29, 2024
Published online: July 18, 2024
Processing time: 112 Days and 20.5 Hours
Abstract
BACKGROUND

Besides return to work (RTW) and return to sports (RTS), patients also prefer to return to daily activities (RTA) such as walking, sleeping, grocery shopping, and domestic work following total knee arthroplasty (TKA). However, evidence on the timelines and probability of patients’ RTA is sparse.

AIM

To assess the percentage of patients able to RTA, RTW, and RTS after TKA, as well as the timeframe and influencing factors of this return.

METHODS

A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital. Assessments of RTA, RTW, and RTS were performed at 3 mo and/or 6 mo following TKA. Investigated factors encompassed patient characteristics, surgical characteristics, and preoperative patient-reported outcomes.

RESULTS

TKA patients [n = 2063; 66 years old (interquartile range [IQR]: 7 years); 47% male; 28 kg/m2 (IQR: 4 kg/m2)] showed RTA ranging from 28% for kneeling to 94% for grocery shopping, with 20 d (IQR: 27 d) spent for putting on shoes to 74 d (IQR: 57 d) for kneeling. RTW rates varied from 62% for medium-impact work to 87% for low-impact work, taking 33 d (IQR: 29 d) to 78 d (IQR: 55 d). RTS ranged from 48% for medium-impact sports to 90% for low-impact sports, occurring within 43 d (IQR: 24 d) to 90 d (IQR: 60 d). One or more of the investigated factors influenced the return to each of the 14 activities examined, with R² values ranging from 0.013 to 0.127.

CONCLUSION

Approximately 80% of patients can RTA, RTW, and RTS within 6 mo after TKA. Return is not consistently influenced by predictive factors. Results help set realistic pre- and postoperative expectations.

Keywords: Knee, Arthroplasty, Replacement, Return to work, Return to daily activities, Return to sports

Core Tip: Everyday, patients with knee osteoarthritis and knee arthroplasty are seen in consultation rooms. In this large sample study (n = 2063 patients), approximately 80% of patients were able to return to daily activities, work, and sports within 6 mo after total knee arthroplasty. Return was not consistently influenced by identifiable predictive factors. This new knowledge creates realistic pre- and postoperative expectations.