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Participation following knee replacement: the MOST cohort study
Jessica L Maxwell1, Julie J Keysor, Jingbo Niu
1J.L. Maxwell, PT, DPT, OCS, Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, 635 Commonwealth Ave, Room 623, Boston University, Boston, MA 02215 (USA).
Physical Therapy
|July 2, 2013
Summary
Participation after total knee replacement (TKR) improves but remains restricted for many. Non-white individuals, women, and those with specific health issues face higher participation barriers post-TKR.
Area of Science:
- Orthopedics
- Rehabilitation Science
- Gerontology
Background:
- Participation is a critical outcome following total knee replacement (TKR), yet it is understudied.
- Understanding participation levels and restrictions is vital for improving patient recovery and quality of life after TKR.
Purpose of the Study:
- To determine the extent of participation and participation restriction after TKR.
- To identify predictors of participation and participation restriction in individuals who have undergone TKR.
Main Methods:
- A longitudinal cohort study (Multicenter Osteoarthritis Study) analyzed changes in pain, function, and participation from pre-TKR to ≥1 year post-TKR.
- Linear and logistic regression models were used to assess associations between demographic/clinical factors and participation/participation restriction.
Main Results:
- Mean improvements in pain, function, and participation were observed post-TKR.
- Approximately 30% of participants experienced participation restriction pre- and post-TKR, with significant improvement only in those <65 years old.
- Non-white individuals, females, and those with depressive symptoms, severe knee pain, or worse pre-TKR function showed higher rates of participation restriction.
Conclusions:
- Despite mean improvements, participation restriction remains a significant issue for a substantial portion of TKR patients.
- Specific demographic (non-white, female) and clinical factors (depressive symptoms, pain severity, pre-TKR function) predict lower participation post-TKR.
- Targeted interventions may be necessary to address persistent participation barriers in vulnerable subgroups after TKR.
