Gender and Preoperative Function Predict Physical Activity Levels After Revision Total Knee Arthroplasty

Area of Science:

• Orthopedics
• Arthroplasty Surgery
• Rehabilitation Science

Background:

• Revision total knee arthroplasty (TKA) incidence is rising globally.
• Younger, active patients undergoing revision TKA require understanding of factors influencing postoperative function.
• Predicting return to physical activity is crucial for patient counseling.

Purpose of the Study:

• To identify factors influencing return to physical activity after revision TKA.
• To analyze the relationship between preoperative and postoperative activity levels.
• To assess patient outcomes including satisfaction and quality of life.

Main Methods:

• Retrospective review of 112 revision TKA cases from a UK teaching hospital (2003-2013).
• Data collected included preoperative activity (UCLA score), demographics, indication, implant type, and Oxford Knee Scores (OKS).
• Postoperative outcomes assessed via questionnaires (UCLA, OKS, EQ-5D, WORQ) and healthcare records at a mean follow-up of 3.9 years.

Main Results:

• Mean UCLA activity scores improved post-revision (P < .001), with 47% showing improvement and 58% achieving moderate or higher activity.
• Postoperative activity was independently predicted by male gender (P = .042) and higher preoperative UCLA score (P < .001).
• Social deprivation correlated with poorer UCLA, EQ-5D, and OKS scores. Younger patients (<65 years) reported higher dissatisfaction and difficulties.

Conclusions:

• While 90% of patients maintain activity after revision TKA, less than half increase their levels.
• Male sex and higher preoperative activity levels are key predictors of increased postoperative physical activity.
• Factors like social deprivation and younger age impact outcomes and satisfaction following revision TKA.