Eight of ten patients return to daily activities, work, and sports after total knee arthroplasty

doi:10.5312/wjo.v15.i7.608

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World Journal of Orthopedics

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Retrospective Cohort Study

World J Orthop. Jul 18, 2024; 15(7): 608-617
Published online Jul 18, 2024. doi: 10.5312/wjo.v15.i7.608

Table 1 Patient characteristics, surgical characteristics, and preoperative patient-reported outcomes, n (%)

Characteristics	Respondents, n = 2063	Nonrespondents, n = 367	P value
Patient characteristics
Age in year, median (IQR)	65.80 (7.19)	65.13 (8.39)	0.222
BMI in kg/m², median (IQR)	27.77 (3.44)	27.84 (3.31)	0.516
Sex, male	973 (47.2)	190 (51.8)	0.112
ASA, I	799 (38.7)	143 (39.0)	0.954
Smoking status, yes	156 (7.6)	42 (11.4)	0.017^a
Alcohol consumption, yes	1499 (72.7)	244 (66.5)	0.020^a
Previous knee surgery, yes	986 (47.8)	173 (47.1)	0.821
Charnley classification			0.113
A Unilateral knee arthritis	972 (47.1)	160 (43.6)
B1 Unilateral knee TKA	482 (23.4)	78 (21.3)
B2 Bilateral TKA	412 (20.0)	94 (25.6)
C more joints affected	197 (9.5)	34 (9.3)
Surgical characteristics
Diagnosis, osteoarthritis	2021 (98.0)	355 (96.7)	0.175
Anesthesia technique, spinal	2043 (99.0)	362 (98.6)	0.763
Operative duration in min, median (IQR)	40.77 (9.51)	41.04 (9.83)	0.551
Complication, yes	62 (3.0)	18 (4.9)	0.078
Preoperative PROs
NRS pain score at rest, median (IQR)	4.92 (2.38)	5.23 (2.43)	0.021^a
NRS pain score during activity, median (IQR)	7.18 (1.88)	7.18 (2.00)	0.558
KOOS-PS score, median (IQR)	47.23 (12.74)	48.98 (14.19)	0.084
EQVAS score, median (IQR)	72.91 (18.65)	72.96 (19.03)	0.906
EQ-5D descriptive system score, median (IQR)	0.590 (0.250)	0.551 (0.273)	0.013^a
OKS, median (IQR)	24.92 (7.16)	23.83 (7.64)	0.042^a

^aP < 0.05.

ASA: American Society of Anesthesiologists score; BMI: Body mass index; EQ-5D descriptive system: EuroQol five dimensions descriptive system; EQ VAS: EuroQol five dimensions Visual Analogue Scale; KOOS-PS: Knee Injury and Osteoarthritis Outcome Score - Physical Function Short Form; NRS: Numeric rating scale; OKS: Oxford knee score; PRO: Patient-reported outcomes; TKA: Total knee arthroplasty; IQR: Interquartile range.

Table 2 Return to daily activities, work, and sports within 6 mo after total knee arthroplasty

Activity	3 mo		6 mo		Within 6 mo
Activity	Return to activity, n (%)¹	Time to return in days, median (IQR)	Return to activity, n (%)¹	Time to return in days, median (IQR)	Return to activity, n (%)¹	Time to return in days, median (IQR)
Daily activities
Night rest	1435 (72.6)	26.0 (36.0)	-	-	1435 (72.6)	26.0 (36.0)
Walking without aids	1859 (94.0)	32.0 (23.5)	-	-	1859 (94.0)	32.0 (23.5)
Stair climbing	1655 (83.7)	42.0 (26.0)	-	-	1655 (83.7)	42.0 (26.0)
Grocery shopping	1867 (94.4)	37.0 (23.0)	-	-	1867 (94.4)	37.0 (23.0)
Domestic work	1700 (86.0)	42.0 (25.0)	-	-	1700 (86.0)	42.0 (25.0)
Putting on shoes/socks	1940 (98.1)	20.0 (27.0)	-	-	1940 (98.1)	20.0 (27.0)
Kneeling	403 (20.4)	57.0 (25.0)	439 (30.0)	96.0 (50.3)	551 (27.7)	74.0 (56.5)
Driving a car	1725 (91.7)	42.0 (20.0)	-	-	1725 (91.7)	42.0 (20.0)
Outdoor cycling	1518 (80.8)	43.0 (24.0)	-	-	1518 (80.8)	43.0 (24.0)
Work
Low-impact work	691 (86.6)	33.0 (29.0)	-	-	691 (86.6)	33.0 (29.0)
Medium-impact work	238 (34.9)	57.0 (24.0)	342 (72.3)	97.0 (54.0)	422 (62.1)	78.0 (55.0)
Sports
Low-impact sports	1588 (89.5)	43.0 (24.0)	-	-	1588 (89.5)	43.0 (24.0)
Medium-impact sports	185 (21.7)	57.0 (26.0)	327 (63.0)	98.0 (52.0)	381 (48.4)	89.5 (60.0)
Swimming	231 (34.9)	51.0 (28.5)	385 (81.6)	90.8 (36.0)	468 (68.6)	80.0 (61.0)

¹Percentages represent the portion of patients who answered “yes” on the questionnaire out of the total number of patients who answered “yes” or “no” to that specific question.

IQR: Interquartile range.

Table 3 Factors predicting return to daily activities, work, and sports within 6 mo after total knee arthroplasty

Activity	n	R²	Predictive factors	OR (95%CI)	P value
Daily activities
Night rest	1901	0.029	Sex	0.734 (0.589-0.913)	0.006^b
			ASA	1.217 (0.989-1.498)	0.064
			Previous surgery	0.829 (0.670-1.025)	0.083
			Operative duration	0.989 (0.978-1.000)	0.047^a
			NRS pain at rest	0.912 (0.863-0.964)	0.001^b
			NRS pain during activity	1.080 (1.003-1.163)	0.042^a
			OKS	1.020 (1.002-1.038)	0.030^a
Walking without aids	1901	0.033	Sex	0.681 (0.456-1.016)	0.06
			Anesthesia technique	4.456 (1.232-16.120)	0.023^a
			OKS	1.054 (1.024-1.084)	< 0.001^b
Stair climbing	1901	0.05	BMI	0.941 (0.908-0.975)	< 0.001^b
			Sex	0.499 (0.381-0.653)	< 0.001^b
			Operative duration	0.987 (0.974-1.000)	0.053
			OKS	1.024 (1.006-1.043)	0.010^a
Grocery shopping	1901	0.051	Age	0.960 (0.933-0.989)	0.007^b
			BMI	0.939 (0.886-0.996)	0.037^a
			EQ-5D descriptive system	0.299 (0.106-0.846)	0.023^a
			OKS	1.094 (1.052-1.137)	< 0.001^b
Domestic work	1901	0.05	Age	0.958 (0.940-0.977)	< 0.001^b
			BMI	0.924 (0.889-0.961)	< 0.001^b
			NRS pain during activity	1.082 (0.995-1.178)	0.067
			OKS	1.054 (1.031-1.078)	< 0.001^b
Putting on shoes/socks	1901	0.067	Sex	2.794 (1.366-5.712)	0.005^b
Putting on shoes/socks	1901	0.067	OKS	1.106 (1.052-1.163)	< 0.001^b
Kneeling	1910	0.1	BMI	0.946 (0.917-0.976)	< 0.001^b
			Sex	0.433 (0.349-0.538)	< 0.001^b
			Alcohol consumption	1.305 (1.015-1.681)	0.039^a
			KOOS-PS	0.989 (0.978-1.001)	0.083
			OKS	1.022 (1.000-1.044)	0.048^a
Driving a car	1811	0.127	Age	0.966 (0.941-0.990)	0.007^b
			Sex	0.217 (0.140-0.337)	< 0.001^b
			ASA	0.678 (0.461-0.998)	0.049^a
			Anesthesia technique	3.815 (0.970-14.998)	0.055
			Charnley classification	1.173 (0.988-1.391)	0.068
			OKS	1.055 (1.028-1.083)	< 0.001^b
Outdoor cycling	1806	0.123	Age	0.949 (0.931-0.967)	< 0.001^b
			BMI	0.937 (0.903-0.972)	< 0.001^b
			Sex	0.347 (0.266-0.452)	< 0.001^b
			ASA	0.763 (0.580-1.004)	0.053
			Charnley classification	1.175 (1.041-1.326)	0.009^b
			OKS	1.032 (1.013-1.051)	< 0.001^b
Work
Low-impact work	765	0.026	Age	1.032 (0.999-1.065)	0.054
Low-impact work	765	0.026	EQ-5D descriptive system	2.540 (1.150-5.612)	0.021^a
Medium-impact work	448	0.069	Alcohol consumption	1.497 (0.932-2.406)	0.095
			EQ VAS	1.015 (1.004-1.027)	0.007^b
			OKS	1.030 (0.997-1.065)	0.075
Sports
Low-impact sports	1705	0.022	Age	1.038 (1.015-1.062)	0.001^b
			ASA	0.728 (0.519-1.021)	0.066
			EQ VAS	1.009 (1.001-1.017)	0.032^a
Medium-impact sports	758	0.028	Operative duration	0.985 (0.971-1.000)	0.044^a
			EQ VAS	1.007 (0.999-1.016)	0.071
			OKS	1.026 (1.004-1.048)	0.018^a
Swimming	658	0.013	EQ-5D descriptive system	0.398 (0.164-0.961)	0.041^a
Swimming	658	0.013	OKS	1.039 (1.007-1.071)	0.016^a

^aP < 0.05.

^bP < 0.01.

Citation: Peters MCWM, Pronk Y, Brinkman JM. Eight of ten patients return to daily activities, work, and sports after total knee arthroplasty. World J Orthop 2024; 15(7): 608-617
URL: https://www.wjgnet.com/2218-5836/full/v15/i7/608.htm
DOI: https://dx.doi.org/10.5312/wjo.v15.i7.608