Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study
Abstract Background Rates of total knee arthroplasty (TKA) procedures in younger, more medically complex patients have dramatically increased over the last several decades. No study has examined categorization of lower and higher functioning subgroups within the TKA patient population. Our study aim...
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doaj-784e05e79d7241ee8d91f0c4e5794c252020-11-25T03:52:48ZengBMCBMC Musculoskeletal Disorders1471-24742019-10-012011910.1186/s12891-019-2817-4Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective studyJesse C. Christensen0Andrew J. Kittelson1Brian J. Loyd2Michael A. Himawan3Charles A. Thigpen4Jennifer E. Stevens-Lapsley5Department of Physical Medicine and Rehabilitation, Eastern Colorado Geriatric Research Education and Clinical CenterDepartment of Physical Medicine and Rehabilitation, University of ColoradoDepartment of Physical Therapy and Athletic Training, University of UtahDepartment of Physical Medicine and Rehabilitation, University of ColoradoATI Physical TherapyDepartment of Physical Medicine and Rehabilitation, Eastern Colorado Geriatric Research Education and Clinical CenterAbstract Background Rates of total knee arthroplasty (TKA) procedures in younger, more medically complex patients have dramatically increased over the last several decades. No study has examined categorization of lower and higher functioning subgroups within the TKA patient population. Our study aimed to determine preoperative characteristics of younger patients who are lower functioning following TKA. Methods Patients were categorized into higher and lower functioning subgroups defined using a median split of 1) postoperative Timed Up and Go (TUG) test times and 2) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale scores. A split in age (65 years) was used to further classify patients into four categories: younger lower functioning, younger higher functioning, older lower functioning and older higher functioning. Measures from preoperative domains of health, psychological, physical performance and pain severity were examined for between-group differences. Results Comparing mean values, the younger lower functioning subgroup using the TUG had significantly weaker knee extensor, slower gait speed, higher body mass index and greater pain compared to other subgroups. The younger lower functioning subgroup using the WOMAC physical function subscale demonstrated higher pain levels and Coping Strategies Questionnaire-Catastrophizing Subscale scores compared to the older lower functioning subgroup. Conclusions Poorer preoperative physical performance and pain severity appear to have the largest influence on early postoperative TKA recovery in younger lower functioning patients relative to both younger and older higher functioning patients.http://link.springer.com/article/10.1186/s12891-019-2817-4Total knee arthroplastyClinical outcomesSubgroupingSelf-reportPhysical performance |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jesse C. Christensen Andrew J. Kittelson Brian J. Loyd Michael A. Himawan Charles A. Thigpen Jennifer E. Stevens-Lapsley |
spellingShingle |
Jesse C. Christensen Andrew J. Kittelson Brian J. Loyd Michael A. Himawan Charles A. Thigpen Jennifer E. Stevens-Lapsley Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study BMC Musculoskeletal Disorders Total knee arthroplasty Clinical outcomes Subgrouping Self-report Physical performance |
author_facet |
Jesse C. Christensen Andrew J. Kittelson Brian J. Loyd Michael A. Himawan Charles A. Thigpen Jennifer E. Stevens-Lapsley |
author_sort |
Jesse C. Christensen |
title |
Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study |
title_short |
Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study |
title_full |
Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study |
title_fullStr |
Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study |
title_full_unstemmed |
Characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study |
title_sort |
characteristics of young and lower functioning patients following total knee arthroplasty: a retrospective study |
publisher |
BMC |
series |
BMC Musculoskeletal Disorders |
issn |
1471-2474 |
publishDate |
2019-10-01 |
description |
Abstract Background Rates of total knee arthroplasty (TKA) procedures in younger, more medically complex patients have dramatically increased over the last several decades. No study has examined categorization of lower and higher functioning subgroups within the TKA patient population. Our study aimed to determine preoperative characteristics of younger patients who are lower functioning following TKA. Methods Patients were categorized into higher and lower functioning subgroups defined using a median split of 1) postoperative Timed Up and Go (TUG) test times and 2) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale scores. A split in age (65 years) was used to further classify patients into four categories: younger lower functioning, younger higher functioning, older lower functioning and older higher functioning. Measures from preoperative domains of health, psychological, physical performance and pain severity were examined for between-group differences. Results Comparing mean values, the younger lower functioning subgroup using the TUG had significantly weaker knee extensor, slower gait speed, higher body mass index and greater pain compared to other subgroups. The younger lower functioning subgroup using the WOMAC physical function subscale demonstrated higher pain levels and Coping Strategies Questionnaire-Catastrophizing Subscale scores compared to the older lower functioning subgroup. Conclusions Poorer preoperative physical performance and pain severity appear to have the largest influence on early postoperative TKA recovery in younger lower functioning patients relative to both younger and older higher functioning patients. |
topic |
Total knee arthroplasty Clinical outcomes Subgrouping Self-report Physical performance |
url |
http://link.springer.com/article/10.1186/s12891-019-2817-4 |
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