Outcomes Vary by Pre-Operative Physical Activity Levels in Total Knee Arthroplasty Patients

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Physical activity (PA) is linked to reduced osteoarthritis pain.
• Patients undergoing arthroplasty may avoid pre-operative physical activity.
• Understanding the role of pre-operative PA in total knee arthroplasty (TKA) outcomes is crucial.

Purpose of the Study:

• To investigate the relationship between pre-operative physical activity levels and outcomes in patients undergoing TKA.
• To compare objective and patient-reported outcomes based on pre-operative activity levels.

Main Methods:

• A multicenter prospective cohort study included 1941 patients undergoing TKA.
• Pre-operative physical activity was categorized into low, moderate, and high based on step count quartiles.
• Pre- and post-operative pain, EQ-5D-5L, KOOS JR scores, and step counts were analyzed using ANOVA.

Main Results:

• Pre-operative pain scores were inversely related to activity levels (p < 0.05).
• The low PA group showed the most significant post-operative pain improvement.
• High PA patients reported smaller improvements in quality of life (EQ-5D-5L) and knee function (KOOS JR) and did not fully return to pre-operative step counts within one year.

Conclusions:

• Higher pre-operative physical activity in TKA patients is associated with lower pre-operative pain and higher function.
• These patients experience less improvement post-operatively compared to lower activity groups.
• Findings can inform patient counseling regarding expectations before TKA.