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Published on: September 7, 2022
Delaying knee replacement and implications on early postoperative outcomes: a pilot study.
Mark D Rossi1, Thomas Eberle, Martin Roche
1College of Nursing and Health Sciences, Department of Physical Therapy, Florida International University, Miami, Florida 33199, USA. rossim@fiu.edu
Patients undergoing delayed total knee replacement (TKR) surgery experienced worse outcomes, including increased pain and functional limitations, compared to those with earlier surgery. Rehabilitation results showed no significant differences in improvement, indicating lasting effects of delayed treatment.
Area of Science:
- Orthopedic Surgery
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Total knee replacement (TKR) is a common procedure for end-stage knee osteoarthritis.
- The impact of surgical delay on postoperative rehabilitation outcomes requires further investigation.
- Patient-reported outcomes and functional performance are key metrics for TKR success.
Purpose of the Study:
- To compare postoperative rehabilitation outcomes between patients with early versus delayed total knee replacement (TKR).
- To evaluate the influence of surgical waiting times on pain, function, and mobility post-TKR.
Main Methods:
- Forty-two patients undergoing unilateral TKR were divided into early (surgery ≤324 days) and late (surgery ≥325 days) surgical groups.
- Preoperative and discharge assessments included the WOMAC, SF-12, Knee Society Score (KSS), squatting ability (SQ30, SQ60), and Timed Up and Go (TUG).
- Statistical analyses included Mann-Whitney, 2x2 ANOVA, and independent t tests to compare groups.
Main Results:
- The late surgical group demonstrated significantly less weight-bearing during squats (SQ30) and longer TUG times.
- Patients with delayed surgery reported greater pain and functional difficulties at the initial visit and discharge.
- While change scores were similar, effect sizes indicated moderate to high impact of delayed surgery on outcomes.
Conclusions:
- Delayed total knee replacement surgery is associated with poorer initial functional status and persistent deficits.
- Patients experiencing longer waiting times for TKR may not achieve the same level of recovery as those with shorter waits.
- Optimizing surgical scheduling is crucial for maximizing rehabilitation potential and patient outcomes after TKR.