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Does total knee replacement restore normal knee function?

Philip C Noble1, Michael J Gordon, Jennifer M Weiss

  • 1Barnhart Department of Orthopedic Surgery, Baylor College of Medicine, 6550 Fannin, Houston, TX 77030, USA. pnoble@bcm.tmc.edu

Clinical Orthopaedics and Related Research
|February 3, 2005
PubMed
Summary
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Total knee arthroplasty patients experience significant functional limitations compared to healthy peers, with aging accounting for only 40% of the deficit. Improvements in surgical techniques and prosthetic designs are needed for better outcomes.

Area of Science:

  • Orthopedics
  • Geriatric Medicine
  • Biomedical Engineering

Background:

  • Total knee arthroplasty (TKA) aims to restore function but often falls short of age-adjusted expectations.
  • Previous assessments overlooked the natural decline in musculoskeletal function with aging.
  • Quantifying TKA outcomes requires considering age-related functional changes.

Purpose of the Study:

  • To determine the effects of aging on knee function.
  • To establish a realistic benchmark for healthy knee function in older adults.
  • To compare functional outcomes of TKA patients against age- and gender-matched healthy controls.

Main Methods:

  • A validated, self-administered questionnaire with 55 questions assessed knee function.
  • Data collected from 243 TKA patients (≥1 year post-op) and 257 healthy controls.

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  • Controls were age- and gender-matched to TKA patients.

    • Main Results:

    • TKA patients reported limitations in 52% of activities, compared to 22% in controls.
    • Knee function declined with age in both groups, with no gender difference.
    • Control group outperformed TKA patients in demanding activities like kneeling, squatting, and cutting.

    Conclusions:

    • Significant functional deficits persist after TKA, with aging explaining only ~40% of the impairment.
    • Limitations in TKA patients are not solely due to aging; many are shared by healthy individuals.
    • Enhanced surgical procedures and prosthetic designs are necessary to achieve normal knee function post-TKA.