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Influence of Comorbidities on Short-Term Functional Outcomes After Unilateral Total Knee Arthroplasty
Youn Ji Kim1, Bo Ryun Kim, Sang Rim Kim
1From the Department of Rehabilitation Medicine, Jeju National University School of Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Republic of Korea (YJK, SYL, JHC, WBK, BSK); Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (BRK); and Department of Orthopedic Surgery, Jeju National University School of Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Republic of Korea (SRK, KWN).
Objective:
The aim of the study was to determine the effect of comorbidities on physical function and quality of life of patients at 3 mos after total knee arthroplasty.
Design:
Data from 140 patients who underwent a primary unilateral total knee arthroplasty were examined retrospectively. Comorbidities were osteoporosis, presarcopenia, degenerative spine disease, diabetes, and hypertension. All patients completed the following: range of motion, stair climbing test, 6-min walk test, Timed Up and Go Test, peak torque of the knee extensor and flexor, instrumental gait analysis, Western Ontario McMaster Universities Osteoarthritis Index, and EuroQoL five-dimension questionnaire.
Results:
Univariate analyses revealed that osteoporosis led to a significantly longer time to complete the stair climbing test-ascent, stair climbing test-descent, and Timed Up and Go Test and to lower scores for the 6-min walk test and peak torque of the knee extensor. Patients with degenerative spine disease showed significant negative scores for knee extension range of motion. Diabetes showed a negative correlation with peak torque of the knee extensor and knee flexion range of motion, as well as a higher Western Ontario McMaster Universities Osteoarthritis Index-stiffness score. Multivariable linear regression analysis showed that Western Ontario McMaster Universities Osteoarthritis Index-stiffness remained independently associated with diabetes. Six-minute walk test, Timed Up and Go Test, stair climbing test-ascent, and peak torque of the knee extensors showed a significant association with osteoporosis.
Conclusions:
Comorbidities, particularly osteoporosis and diabetes, affect short-term functional outcomes 3 mos after total knee arthroplasty.
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