Self‐Reported Knee Instability Before and After Total Knee Replacement Surgery. Issue 4 (24th March 2016)

• Record Type: Journal Article
• Authors: Fleeton, Genevieve; Harmer, Alison R.; Nairn, Lillias; Crosbie, Jack; March, Lyn; Crawford, Ross; van der Esch, Martin; Fransen, Marlene
• Is Part Of: Arthritis care & research. Volume 68:Issue 4(2016:Apr.)
• Page Start: 463
• Page End: 471
• Publication Date: 2016-03-24
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.22692
• Languages: English
• ISSNs: 2151-464X

Abstract

Abstract : Objective: To determine the prevalence and burden of pain and activity limitations associated with retaining presurgery self‐reported knee instability 6 months after total knee replacement (TKR) surgery and to identify early potentially modifiable risk factors for retaining knee instability in the operated knee after TKR surgery. Methods: A secondary analysis was performed using measures obtained from 390 participants undergoing primary unilateral TKR and participating in a randomized clinical trial. Self‐reported knee instability was measured using 2 items from the Activities of Daily Living Scale of the Knee Outcome Survey. Outcome measures were knee pain (range 0–20) and physical function (range 0–68) on the Western Ontario and McMaster Universities Arthritis Index (WOMAC), stair‐climb power, 50‐foot walk time, knee range of motion, and isometric knee flexion and extension strength. Results: In this study, 72% of participants reported knee instability just prior to surgery, with 32% retaining instability in the operated knee 6 months after surgery. Participants retaining operated knee instability had significantly more knee pain and activity limitations 6 months after surgery, with mean ± SD WOMAC scores of 4.8 ± 3.7 and 17.5 ± 11.1, respectively, compared to participants without knee instability, with 2.9 ± 3.1 and 9.8 ± 9.2. The multivariable predictor model for retained knee instability included a high comorbidity score (>6), low stair‐climb power (<150 watts), more pain in the operated knee (>7 of 20), and younger age (<60 years). Conclusion: Self‐reported knee instability is highly prevalent before and after TKR surgery and is associated with a considerable burden of pain and activity limitation in the operated knee. Increasing lower extremity muscle power may reduce the risk of retaining knee instability after TKR surgery.