Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study

Area of Science:

• Orthopedics
• Rheumatology
• Biostatistics

Background:

• Knee replacement surgery is common for osteoarthritis.
• Understanding patient-reported outcomes pre- and post-surgery is crucial.
• Longitudinal data on both knees is needed.

Purpose of the Study:

• To determine preoperative worsening and postoperative recovery trajectories for the index and contralateral knees.
• To analyze changes in function, activity, and participation over time.

Main Methods:

• Analysis of 5-year data from 177 patients in the Osteoarthritis Initiative cohort.
• Isolated unilateral knee replacement surgery patients were included.
• Growth-curve modeling examined International Classification of Functioning, Disability, and Health domains.

Main Results:

• Significant preoperative worsening in index knee impairment, activity limitation, and participation.
• Index knee pain worsened substantially in the 2.5 years before surgery.
• Contralateral knee pain and activity limitation worsened by 2-3 years post-surgery.

Conclusions:

• Knee replacement surgery patients show significant perioperative changes affecting both knees.
• Escalating pain and function decline in the index knee ~2.5 years prior to surgery may trigger surgical decisions.
• Contralateral knee function also deteriorates post-surgery.