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    The Western Ontario and McMaster Universities Osteoarthritis Index physical function subscale (WOMAC-PF) misses many activities important to patients after total knee replacement (TKR). This suggests the WOMAC-PF may not fully capture functional recovery post-TKR.

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    Area of Science:

    • Orthopedics
    • Rehabilitation Medicine
    • Biomedical Engineering

    Background:

    • The Western Ontario and McMaster Universities Osteoarthritis Index physical function subscale (WOMAC-PF) is a standard measure for knee osteoarthritis.
    • Its suitability for assessing functional recovery after total knee replacement (TKR) is debated, as contemporary TKR outcomes may exceed the scale's scope.
    • Patients undergoing TKR with advanced techniques expect higher functional performance levels.

    Purpose of the Study:

    • To evaluate if the WOMAC-PF adequately reflects activity limitations experienced by patients post-TKR.
    • To compare patient-reported limitations using the WOMAC-PF against those identified via the Canadian Occupational Performance Measure (COPM).

    Main Methods:

    • A descriptive study utilizing baseline data from a randomized clinical trial on exercise interventions post-TKR.
    • Participants completed both the WOMAC-PF and COPM on the same day.
    • Responses were analyzed to identify discrepancies in captured activity limitations.

    Main Results:

    • The WOMAC-PF failed to capture 50% of activity limitations reported by patients in the COPM.
    • Key uncaptured activities include kneeling, squatting, lifting, advanced exercises, floor transfers, and varied mobility tasks (e.g., hills, stairs, curbs).
    • Only 'going shopping' from the WOMAC-PF was not identified by participants in the COPM.

    Conclusions:

    • The WOMAC-PF does not fully represent the spectrum of activities and functional demands important to patients after TKR.
    • The scale may underestimate functional recovery, particularly for higher-level physical activities.
    • Further research may be needed to develop or refine outcome measures for post-TKR functional assessment.