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Self-Reported Knee Instability Before and After Total Knee Replacement Surgery.

Genevieve Fleeton1, Alison R Harmer1, Lillias Nairn1

  • 1University of Sydney, Sydney, New South Wales, Australia.

Arthritis Care & Research
|August 29, 2015
PubMed
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Many patients report knee instability before and after total knee replacement (TKR). Retained instability after TKR significantly increases pain and limits activity, but strengthening exercises may help.

Area of Science:

  • Orthopedic Surgery
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Knee instability is a common concern for patients undergoing total knee replacement (TKR).
  • Understanding the prevalence and impact of persistent knee instability post-TKR is crucial for improving patient outcomes.
  • Identifying modifiable risk factors can guide interventions to mitigate long-term limitations.

Purpose of the Study:

  • To determine the prevalence and burden of pain and activity limitations in patients with self-reported knee instability 6 months after TKR.
  • To identify early, potentially modifiable risk factors associated with retaining knee instability after TKR.

Main Methods:

  • Secondary analysis of 390 participants from a randomized clinical trial undergoing primary unilateral TKR.

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  • Knee instability assessed using the Knee Outcome Survey Activities of Daily Living Scale.
  • Outcomes included WOMAC pain and function, stair-climb power, walk time, range of motion, and muscle strength.

    • Main Results:

    • Pre-surgery knee instability was reported by 72% of participants; 32% retained instability 6 months post-TKR.
    • Patients with retained instability experienced significantly higher knee pain (WOMAC 4.8 vs. 2.9) and activity limitations (WOMAC 17.5 vs. 9.8).
    • Predictors of retained instability included high comorbidity score, low stair-climb power, greater post-op knee pain, and younger age.

    Conclusions:

    • Self-reported knee instability is highly prevalent both before and after TKR.
    • Retained knee instability post-TKR is linked to substantial pain and functional limitations.
    • Enhancing lower extremity muscle power may be a key strategy to reduce the risk of persistent knee instability after TKR.