Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 25;13(1):125.
doi: 10.3390/jcm13010125.

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

Roberta E Redfern  1 , David A Crawford  2 , Adolph V Lombardi Jr  2 , Krishna R Tripuraneni  3 , David C Van Andel  1 , Mike B Anderson  1 , Jason M Cholewa  1
Affiliations

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

Roberta E Redfern et al. J Clin Med. .

Abstract

Physical activity (PA) is suggested to reduce osteoarthritis pain; however, it may be avoided by patients requiring arthroplasty. Our goal was to investigate objective and patient-reported outcomes as a function of pre-operative PA levels in patients undergoing total knee arthroplasty (TKA). A total of 1941 patients enrolled in a multicenter prospective cohort study investigating a smartphone-based care management platform for self-directed rehabilitation underwent TKA and were included in the analysis. Activity was categorized based on the cohort's step count quartiles into low, moderate, and high pre-operative PA. Pre-operative and post-operative pain, EQ5D5L, KOOS JR, and step counts were compared by ANOVA according to activity group. Pre-operative pain scores increased with the decreasing activity level (all, p < 0.05) and were most improved post-operatively in the low PA group. High PA patients demonstrated the smallest improvements in EQ-5D-5L and KOOS JR. Low and moderate PA patients increased physical activity by three months, reaching 176% and 104% of pre-operative steps; high PA patients did not return to full step counts by one year post-operatively. Patients undergoing TKA who present with higher levels of physical activity report lower levels of pain and higher function pre-operatively but appreciate less improvement up to one year post-operatively. These results may be helpful in appropriate counseling of patient expectations before TKA.

Keywords: mobile health; physical activity; step count; total knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

RER—employed by Zimmer Biomet, stock or stock options. DAC, research support—FirstKind, Parvizi Surgical Innovation Research Institute, Prescribe Fit, Recovery Rx, SI-Bone, Smith & Nephew, SPR Therapeutics, Total Joint Orthopedics, Zimmer Biomet; paid consultant Depuy, Medacta; paid presenter or speaker, Medacta; editorial or governing board Journal or Orthopedic Experience and Innovation. AVL, research support—Firstkind, Parvizi Surgical Innovation Research Institute, Prescribe Fit, Recovery Rx, SI-Bone, Smith & Nephew, SPR Therapeutics, Total Joint Orthopedics, Zimmer Biomet. IP royalties—Innomed, Zimmer Biomet; paid consultant—Zimmer Biomet; stock or stock options—JIS Ventures, Joint Development Corporation, Parvizi Surgical Innovation, Prescribe Fit; editorial or governing board—Clinical Orthopaedics and Related Research, Journal of Arthroplasty, Journal of Bone and Joint Surgery, Journal of Orthopaedics and Traumatology, Journal of the American Academy of Orthopaedic Surgeons, Knee, Surgical Technology International, The Bone & Joint Journal; board or committee member—Central Ohio Orthipaedica Management Company, Current Concepts in Joint Replacement, Operation Walk USA. KRT, research support—Zimmer Biomet; paid consultant—Exactech, Inc.; stock or stock options—Alio, Sparta Biomedical; editorial or governing board—Arthroplasty Today, Journal of Arthroplasty. DVA—employed by Zimmer Biomet, stock or stock options. MBA—employed by Zimmer Biomet, stock or stock options; stock OrthoGrid systems. JMC—employed by Zimmer Biomet, stock or stock options.

Figures

Figure 1
Figure 1
Step count recovery curves as a function of baseline activity.
See this image and copyright information in PMC

References

    1. Cui A., Li H., Wang D., Zhong J., Chen Y., Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. eClinicalMedicine. 2020;29–30:100587. doi: 10.1016/j.eclinm.2020.100587. - DOI - PMC - PubMed
    1. Kingsbury S.R., Gross H.J., Isherwood G., Conaghan P.G. Osteoarthritis in Europe: Impact on health status, work productivity and use of pharmacotherapies in five European countries. Rheumatology. 2014;53:937–947. doi: 10.1093/rheumatology/ket463. - DOI - PubMed
    1. Conley B., Bunzli S., Bullen J., O’Brien P., Persaud J., Gunatillake T., Dowsey M.M., Choong P.F.M., Lin I. Core Recommendations for Osteoarthritis Care: A Systematic Review of Clinical Practice Guidelines. Arthritis Care Res. 2023;75:1897–1907. doi: 10.1002/acr.25101. - DOI - PMC - PubMed
    1. Abou-Raya S., Abou-Raya A., Kareem A.A. SAT0314 Effects of Physical Activity on Inflammation, Skeletal Muscle Strength/Function (Sarcopenia) and Fat Infiltration (Sarcopenic Obesity) in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial. Ann. Rheum. Dis. 2013;72:A690. doi: 10.1136/annrheumdis-2013-eular.2039. - DOI
    1. Hu B., Han D., Nevitt M.C., Wise B.L., Segal N.A. Longitudinal Relationship Between Physical Activity and Joint Space Narrowing: Forty-Eight-Month Follow-Up Data From the Osteoarthritis Initiative. Arthritis Care Res. 2022;74:1163–1171. doi: 10.1002/acr.24554. - DOI - PMC - PubMed

LinkOut - more resources