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Published on: February 22, 2020
Predicting functional performance and range of motion outcomes after total knee arthroplasty
Michael J Bade1, John M Kittelson, Wendy M Kohrt
1From the Rueckert-Hartman College for Health Professions, School of Physical Therapy, Regis University, Denver, Colorado (MJB); Department of Biostatistics & Informatics, University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Aurora, CO (JMK); and Department of Geriatrics (WMK) and Department of Physical Medicine and Rehabilitation (JES-L), University of Colorado Anschutz Medical Campus, School of Medicine.
Objective:
The aim of this study was to assess the predictive value of functional performance and range of motion measures on outcomes after total knee arthroplasty.
Design:
This is a secondary analysis of two pooled prospective randomized controlled trials. Sixty-four subjects (32 men and 32 women) with end-stage knee osteoarthritis scheduled to undergo primary total knee arthroplasty were enrolled. Active knee flexion and extension range of motion, Timed Up and Go (TUG) test time, and 6-min walk test distance were assessed.
Results:
Preoperative measures of knee flexion and extension were predictive of long-term flexion (β = 0.44, P < 0.001) and extension (β = 0.46, P < 0.001). Acute measures of knee flexion and extension were not predictive of long-term flexion (β = 0.09, P = 0.26) or extension (β = 0.04, P = 0.76). Preoperative TUG performance was predictive of long-term 6-min walk performance (β = -21, P < 0.001). Acute TUG performance was predictive of long-term functional performance on the 6-min walk test, after adjusting for the effects of sex and age (P = 0.02); however, once adjusted for preoperative TUG performance, acute TUG was no longer related to long-term 6-min walk performance (P = 0.65).
Conclusions:
Acute postoperative measures of knee range of motion are of limited prognostic value, although preoperative measures have some prognostic value. However, acute measures of functional performance are of useful prognostic value, especially when preoperative functional performance data are unavailable.
