Investigation of mid-term functional skills and psychological factors in female patients undergoing total knee arthroplasty

Functional skills after total knee arthroplasty

Authors

Keywords:

total knee arthroplasty, functional skills, psychological factors, osteoarthritis

Abstract

Background/Aim: Previous studies have yielded conflicting clinical, psychological, and functional outcomes in patients undergoing total knee arthroplasty (TKA). This study aimed to more precisely evaluate the clinical outcomes, mid-term general physical and psychological health status, functional abilities, and improvements in patients’ quality-of-life undergoing TKA.

Methods: This cross-sectional study included 25 female patients older than 55 years who underwent unilateral TKA due to osteoarthritis (OA). The Five Repetition Sit-to-Stand Test (5STS), Stair-Climbing Test (SCT), 6-Minute Walking Test (6MWT), Berg Balance Scale (BBS), Tampa Scale for Kinesiophobia (TSK), and Short Form Health Survey (SF-12) scores of the patients were evaluated using means. Meanwhile, the Lower Limb Length (LLL), Navicular Drop Test (NDT), Proprioception Assessment, Foot Posture Index (FPI-6), Foot Function Index (FFI), Lower Extremity Functional Scale (LEFS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS) were evaluated by comparing the operated (OP) sides that underwent TKA with the non-operated (NONOP) sides diagnosed with OA.

Results: The study found that LLL (P=0.001), abduction/adduction forefoot on rearfoot (ABD) (P=0.017), and T.FPI-6 (P=0.014) in the FPI-6 parameters, as well as KOOS (P<0.001), OKS (P<0.001), LEFS (P<0.001), and FFI (P<0.001) results, were significantly in favor of the OP limb. Besides some parameters in FPI-6, no significant difference was found between the OP and NONOP extremities in terms of prone and supine proprioception values (P>0.05).

Conclusion: Overall, it was found that TKA plays a crucial role in recovery and regaining functional skills. Including preoperative evaluations with a control group and patients of both sexes in future studies and examining the relationships between the conducted tests and scales may contribute to better evaluating the results.

Downloads

Download data is not yet available.

References

Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780–5. doi: 10.2106/JBJS.F0.00222. DOI: https://doi.org/10.2106/JBJS.F.00222

Sönmez MM, Berk A, Uğurlar M, Ertürer RE, Akman Ş, Öztürk İ. Total diz protezi uygulanan hastaların orta dönem klinik ve radyolojik sonuçlarının değerlendirilmesi. The Medical Bulletin of Şişli Etfal Hospital. 2016;50:115–23. doi: 10.5350/SEMB.20160315022015. DOI: https://doi.org/10.5350/SEMB.20160315022015

Uysal FG, Başaran S. Diz osteoartriti. Turk J Phys Med Rehabil. 2009;55:1–7.

Gioe TJ, Stroemer ES, Santos ERG. All-polyethylene and metal-backed tibias have similar outcomes at 10 years. Clin Orthop Relat Res. 2007;455:212–8. doi: 10.1097/01.blo0.0000238863.69486.97. DOI: https://doi.org/10.1097/01.blo.0000238863.69486.97

Wang WJ, Crompton RH. Analysis of the human and ape foot during bipedal standing with implications for the evolution of the foot. J Biomech. 2004;37:1831–6. doi: 10.1016/j.jbiomech.20040.020.036. DOI: https://doi.org/10.1016/j.jbiomech.2004.02.036

Gill SV, Lewis CL, DeSilva JM. arch height mediation of obesity-related walking in adults: contributors to physical activity limitations. J Physiol. 2014;2014:1–8. doi: 10.1155/2014/821482. DOI: https://doi.org/10.1155/2014/821482

Marenčáková J, Svoboda Z, Vařeka I, Zahálka F. Functional clinical typology of the foot and kinematic gait parameters. Acta Gymnica. 2016;46:74–81. doi: 10.5507/ag.20160.004. DOI: https://doi.org/10.5507/ag.2016.004

Razeghi M, Batt ME. Foot type classification=a critical review of current methods. Gait Posture. 2002;15:282–91. doi: 10.1016/S0966-6362(01)00151-5. DOI: https://doi.org/10.1016/S0966-6362(01)00151-5

Nachbauer W, Nigg BM. Effects of arch height of the foot on ground reaction forces in running. Med Sci Sports Exerc. 1992;24:1264–9. doi: https://doi.org/10.1249/00005768-199211000-00011. DOI: https://doi.org/10.1249/00005768-199211000-00011

Garsden LR, Bullock-Saxton JE. Joint reposition sense in subjects with unilateral osteoarthritis of the knee. Clin Rehabil. 1999;13:148–55. doi: 10.1191/026921599674996411. DOI: https://doi.org/10.1191/026921599674996411

Erkmen N, Suveren S, Göktepe AS, Yazıcıoğlu K. Farklı branşlardaki sporcuların denge performanslarının karşılaştırılması. SPORMETRE Beden Eğitimi ve Spor Bilimleri Dergisi. 2007;5:115–22. doi: 10.1501/Sporm_0000000080. DOI: https://doi.org/10.1501/Sporm_0000000080

Sharma L. Proprioceptive impairment in knee osteoarthritis. Rheum Dis Clin North Am. 1999;25:299–314. doi: 10.1016/S0889-857X(05)70069-7. DOI: https://doi.org/10.1016/S0889-857X(05)70069-7

Fonseca ST, Ocarino JM, Silva PLP, Guimarães RB, Oliveira MCT, Lage CA. Proprioception in individuals with ACL-deficient knee and good muscular and functional performance. Res Sports Med. 2005;13:47–61. doi: 10.1080/15438620590922095. DOI: https://doi.org/10.1080/15438620590922095

Reider B, Arcand MA, Diehl LH, Mroczek K, Abulencia A, Stroud CC, et al Proprioception of the knee before and after anterior cruciate ligament reconstruction. Arthroscopy. 2003;19:2–12. doi: 10.1053/jars.2003.50006. DOI: https://doi.org/10.1053/jars.2003.50006

Kinikli Gİ, Güney H, Karaman A, Yilmaz K, Çağlar Ö, Yüksel İ. Functional mobility on discharge day after total knee and hip replacement surgery. Turkish Journal of Physiotherapy and Rehabilitation. 2014;25:5. doi: 10.7603/s40680-014-0005-x. DOI: https://doi.org/10.7603/s40680-014-0005-x

Doménech J, Sanchis-Alfonso V, Espejo B. Changes in catastrophizing and kinesiophobia are predictive of changes in disability and pain after treatment in patients with anterior knee pain. Knee Surg Sports Traumatol Arthrosc. 2014;22:2295–300. doi: 10.1007/s00167-014-2968-7. DOI: https://doi.org/10.1007/s00167-014-2968-7

Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000;71:262–7. doi: 10.1080/000164700317411852. DOI: https://doi.org/10.1080/000164700317411852

Meier W, Mizner R, Marcus R, Dibble L, Peters C, Lastayo PC. Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. J Orthop Sports Phys Ther. 2008;38:246–56. doi: 10.2519/jospt.2008.2715. DOI: https://doi.org/10.2519/jospt.2008.2715

Wylde V, Blom AW, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC. Patient-reported outcomes after total hip and knee arthroplasty. J Arthroplasty. 2009;24:210–6. doi: 10.1016/j.arth.2007.120.001. DOI: https://doi.org/10.1016/j.arth.2007.12.001

Fisher S, Ottenbacher KJ, Goodwin JS, Graham JE, Ostir G V. Short Physical Performance Battery in hospitalized older adults. Aging Clin Exp Res. 2009;21:445–52. doi: 10.1007/BF03327444. DOI: https://doi.org/10.1007/BF03327444

Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord. 2005;6:1–12. doi: 10.1186/1471-2474-6-3. DOI: https://doi.org/10.1186/1471-2474-6-3

Walsh M, Woodhouse LJ, Thomas SG, Finch E. Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Phys Ther. 1998;78:248–58. doi: 10.1093/ptj/78.3.248. DOI: https://doi.org/10.1093/ptj/78.3.248

Jakobsen TL, Kehlet H, Bandholm T. Reliability of the 6-min walk test after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2013;21:2625–8. doi: 10.1007/s00167-012-2054-y. DOI: https://doi.org/10.1007/s00167-012-2054-y

Ko V, Naylor JM, Harris IA, Crosbie J, Yeo AE. The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC Musculoskelet Disord. 2013;14:1–9. doi: 10.1186/1471-2474-14-145. DOI: https://doi.org/10.1186/1471-2474-14-145

Bogle Thorbahn LD, Newton RA. Use of the Berg Balance Test to predict falls in elderly persons. Phys Ther. 1996;76:576–83. doi: 10.1093/ptj/76.6.576. DOI: https://doi.org/10.1093/ptj/76.6.576

Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73:1073–80. http://www.ncbi.nlm.nih.gov/pubmed/1444775.

Morrison SC, Durward BR, Watt GF, Donaldson MDC. Literature review evaluating the role of the navicular in the clinical and scientific examination of the foot. Br J Pod. 2004;7:110–4.

Loudon JK, Jenkins W, Loudon KL. The Relationship between static posture and ACL injury in female athletes. J Orthop Sports Phys Ther. 1996;24:91–7. doi: 10.2519/jospt.1996.24.2.91. DOI: https://doi.org/10.2519/jospt.1996.24.2.91

Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the foot posture index. Clin Biomech. 2006;21:89–98. DOI: https://doi.org/10.1016/j.clinbiomech.2005.08.002

Landorf KB, Keenan A-M. An evaluation of two foot-specific, health-related quality-of-life measuring instruments. Foot Ankle Int. 2002;23:538–46. doi: 10.1177/107110070202300611. DOI: https://doi.org/10.1177/107110070202300611

Yalıman A, Şen EI, Eskiyurt N, Budiman-Mak E. Turkish translation and adaptation of foot function index in patients with plantar fasciitis. Turk J Phys Med Rehabil. 2014;60:212–22. doi: 10.5152/tftrd.2014.26086. DOI: https://doi.org/10.5152/tftrd.2014.26086

Swinkels-Meewisse EJC., Swinkels RAH., Verbeek AL., Vlaeyen JW., Oostendorp RA. Psychometric properties of the Tampa Scale for kinesiophobia and the fear-avoidance beliefs questionnaire in acute low back pain. Man Ther. 2003;8:29–36. doi: 10.1054/math.20020.0484. DOI: https://doi.org/10.1054/math.2002.0484

Paker N, Buğdaycı D, Sabırlı F, Özel S, Ersoy S. Knee Injury and Osteoarthritis Outcome Score: reliability and validation of the Turkish version. Türkiye Klinikleri Journal of Medical Sciences. 2007;27:350–6.

Perruccio AV, Stefan Lohmander L, Canizares M, Tennant A, Hawker GA, Conaghan PG, et al. The development of a short measure of physical function for knee OA KOOS-Physical Function Shortform (KOOS-PS) – an OARSI/OMERACT initiative. Osteoarthritis Cartilage. 2008;16:542–50. doi: 10.1016/j.joca.2007.12.014. DOI: https://doi.org/10.1016/j.joca.2007.12.014

Clement ND, Macdonald D, Burnett R. Predicting patient satisfaction using the Oxford knee score: where do we Ndraw the line? Arch Orthop Trauma Surg. 2013;133:689–94. doi: 10.1007/s00402-013-1728-3. DOI: https://doi.org/10.1007/s00402-013-1728-3

Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, et al. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum. 2009;61:174–83. doi: 10.1002/art.24167. DOI: https://doi.org/10.1002/art.24167

Chinnappa J, Chen DB, Harris IA, MacDessi SJ. Predictors and functional implications of change in leg length after total knee arthroplasty. J Arthroplasty. 2017;32:2725-29.e1. doi: 10.1016/j.arth.20170.040.007. DOI: https://doi.org/10.1016/j.arth.2017.04.007

Konyves A, Bannister GC. The importance of leg length discrepancy after total hip arthroplasty. J Bone Joint Surg Br. 2005;87-B:155–7. doi: 10.1302/0301-620X.87B2.14878. DOI: https://doi.org/10.1302/0301-620X.87B2.14878

Lang JE, Scott RD, Lonner JH, Bono J V., Hunter DJ, Li L. Magnitude of limb lengthening after primary total knee arthroplasty. J Arthroplasty. 2012;27:341–6. doi: 10.1016/j.arth.20110.060.008. DOI: https://doi.org/10.1016/j.arth.2011.06.008

Kim SH, Rhee S-M, Lim J-W, Lee H-J. The effect of leg length discrepancy on clinical outcome after TKA and identification of possible risk factors. Knee Surg Sports Traumatol Arthrosc. 2016;24:2678–85. doi: 10.1007/s00167-015-3866-3. DOI: https://doi.org/10.1007/s00167-015-3866-3

Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Fotoohabadi MR, et al. Dynamic foot function changes following total knee replacement surgery. Knee. 2012;19:880–5. doi: 10.1016/j.knee.20120.050.002. DOI: https://doi.org/10.1016/j.knee.2012.05.002

Kamalakannan M, Angelkanipreethi H, Gifta A, Sharon A. Efficacy of short foot exercise on medial compartment osteoarthritis knee among subjects with overpronated foot. Drug Invent Today. 2019;11.

Abourazzak FE, Kadi N, Azzouzi H, Lazrak F, Najdi A, Nejjari C, et.al. A positive association between foot posture index and medial compartment knee osteoarthritis in moroccan people. Open Rheumatol J. 2014;8:96–9. doi: 10.2174/1874312901408010096. DOI: https://doi.org/10.2174/1874312901408010096

Gosavi PM, Kolke SS, Chitre J, Shyam A, Sancheti P. Foot posture assessment in people with primary medial compartment knee osteoarthritis: An observational study. Physiother J Indian Assoc Physiother. 2021;15:12.

Metcalf B, Paterson KL, Campbell PK, Wrigley TV, Kasza J, Bennell KL, et al. Relationship between static foot posture, in-shoe plantar forces and knee pain in people with medial knee osteoarthritis. Osteoarthritis Cartilage. 2019;27:S120–1. doi: 10.1016/j.joca.20190.02.178. DOI: https://doi.org/10.1016/j.joca.2019.02.178

Reilly K, Barker K, Shamley D, Newman M, Oskrochi GR, Sandall S. The role of foot and ankle assessment of patients with lower limb osteoarthritis. Physiotherapy. 2009;95:164–9. doi: 10.1016/j.physio.20090.040.003. DOI: https://doi.org/10.1016/j.physio.2009.04.003

Tribhuvan S, Kulkarni N. Correlation between foot posture index (FPI) and knee osteoarthritis (OA) in elderly individuals. International Journal of Multidisciplinary Research and Development. 2019;4:39–43.

Yüksel E, Kalkan S, Çekmece S, Ünver B, Karatosun V. Assessing minimal detectable changes and test-retest reliability of the timed up and go test and the 2-minute walk test in patients with total knee arthroplasty. J Arthroplasty. 2017;32:426–30. doi: 10.1016/j.arth.20160.070.031. DOI: https://doi.org/10.1016/j.arth.2016.07.031

Schilke JM, Johnson GO, Housh TJ, O’Dell JR. Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint. Nurs Res. 1996;45:68–72. doi: 10.1097/00006199-199603000-00002. DOI: https://doi.org/10.1097/00006199-199603000-00002

Heiberg KE, Bruun-Olsen V, Ekeland A, Mengshoel AM. Effect of a walking skill training program in patients who have undergone total hip arthroplasty: Followup one year after surgery. Arthritis Care Res (Hoboken). 2012;64:415–23. doi: 10.1002/acr.20681. DOI: https://doi.org/10.1002/acr.20681

Medina-Mirapeix F, Vivo-Fernández I, López-Cañizares J, García-Vidal JA, Benítez-Martínez JC, del Baño-Aledo ME. Five times sit-to-stand test in subjects with total knee replacement: Reliability and relationship with functional mobility tests. Gait Posture. 2018;59:258–60. doi: 10.1016/j.gaitpost.2017.100.028. DOI: https://doi.org/10.1016/j.gaitpost.2017.10.028

Kiyohara M, Hamai S, Okazaki K, Fujiyoshi D, Mizu-uchi H, Nakashima Y. Evaluation of the balance function before and after total knee arthroplasty using Berg balance scale. Arch Orthop Trauma Surg. 2021;142:3461–7. doi: 10.1007/s00402-021-04233-z. DOI: https://doi.org/10.1007/s00402-021-04233-z

Cai L, Gao H, Xu H, Wang Y, Lyu P, Liu Y. Does a program based on cognitive behavioral therapy affect kinesiophobia in patients following total knee arthroplasty? a randomized, controlled trial with a 6-month follow-up. J Arthroplasty. 2018;33:704–10. doi: 10.1016/j.arth.2017.100.035. DOI: https://doi.org/10.1016/j.arth.2017.10.035

Doury-Panchout F, Metivier J-C, Fouquet B. Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty. Eur J Phys Rehabil Med. 2015;51:155–61. http://www.ncbi.nlm.nih.gov/pubmed/25392087.

Brown ML, Plate JF, Von Thaer S, Fino NF, Smith BP, Seyler TM, et.al. Decreased range of motion after total knee arthroplasty is predicted by the tampa scale of kinesiophobia. J Arthroplasty. 2016;31:793–7. doi: 10.1016/j.arth.2015.100.037. DOI: https://doi.org/10.1016/j.arth.2015.10.037

Kwon SK, Kang YG, Kim SJ, Chang CB, Seong SC, Kim TK. Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty. J Arthroplasty. 2010;25:1125–30. doi: 10.1016/j.arth.2009.100.015. DOI: https://doi.org/10.1016/j.arth.2009.10.015

Odum SM, Fehring TK. Can original knee society scores be used to estimate new 2011 knee society scores? Clin Orthop Relat Res. 2017;475:160–7. doi: 10.1007/s11999-016-4886-0. DOI: https://doi.org/10.1007/s11999-016-4886-0

Webster KE, Feller JA. Comparison of the short form-12 (SF-12) health status questionnaire with the SF-36 in patients with knee osteoarthritis who have replacement surgery. Knee Surg Sports Traumatol Arthrosc. 2016;24:2620–6. doi: 10.1007/s00167-015-3904-1. DOI: https://doi.org/10.1007/s00167-015-3904-1

Canfield M, Savoy L, Cote MP, Halawi MJ. Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window. Arthroplast Today. 2020;6:62–7. doi: 10.1016/j.artd.2019.100.003. DOI: https://doi.org/10.1016/j.artd.2019.10.003

Conner-Spady BL, Marshall DA, Bohm E, Dunbar MJ, Noseworthy TW. Comparing the validity and responsiveness of the EQ-5D-5L to the Oxford hip and knee scores and SF-12 in osteoarthritis patients 1 year following total joint replacement. Qual Life Res. 2018;27:1311–22. doi: 10.1007/s11136-018-1808-5. DOI: https://doi.org/10.1007/s11136-018-1808-5

Davis AM, Perruccio AV, Canizares M, Hawker GA, Roos EM, Maillefert J-F, et al. Comparative, validity and responsiveness of the HOOS-PS and KOOS-PS to the WOMAC physical function subscale in total joint replacement for Osteoarthritis. Osteoarthritis Cartilage. 2009;17:843–7. doi: 10.1016/j.joca.20090.010.005. DOI: https://doi.org/10.1016/j.joca.2009.01.005

Goh GS, Bin Abd Razak HR, Tay DK-J, Lo N-N, Yeo S-J. Early post-operative oxford knee score and knee society score predict patient satisfaction 2 years after total knee arthroplasty. Arch Orthop Trauma Surg. 2021;141:129–37. doi: 10.1007/s00402-020-03612-2. DOI: https://doi.org/10.1007/s00402-020-03612-2

Medalla GA, Moonot P, Peel T, Kalairajah Y, Field RE. Cost-benefit comparison of the oxford knee score and the American knee society score in measuring outcome of total knee arthroplasty. J Arthroplasty. 2009;24:652–6. doi: 10.1016/j.arth.20080.030.020. DOI: https://doi.org/10.1016/j.arth.2008.03.020

Jogi P, Kramer JF, Birmingham T. Comparison of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Lower Extremity Functional Scale (lefs) questionnaires in patients awaiting or having undergone total knee arthroplasty. Physiotherapy Canada. 2005;57:208–16. doi: 10.3138/ptc.57.3.208. DOI: https://doi.org/10.3138/ptc.57.3.208

di Laura Frattura G, Zaffagnini S, Filardo G, Romandini I, Fusco A, Candrian C. Total knee arthroplasty in patients with knee osteoarthritis: effects on proprioception. a systematic review and best evidence synthesis. J Arthroplasty. 2019;34:2815–22. doi: 10.1016/j.arth.20190.060.005. DOI: https://doi.org/10.1016/j.arth.2019.06.005

Xue Y-Y, Shi J-N, Zhang K, Zhang H-H, Yan S-H. The effects of total knee arthroplasty on knee proprioception of patients with knee osteoarthritis: a meta-analysis. J Orthop Surg Res. 2022;17:258. doi: 10.1186/s13018-022-03142-0. DOI: https://doi.org/10.1186/s13018-022-03142-0

Pohl T, Brauner T, Wearing S, Stamer K, Horstmann T. Effects of sensorimotor training volume on recovery of sensorimotor function in patients following lower limb arthroplasty. BMC Musculoskelet Disord. 2015;16:195. doi: 10.1186/s12891-015-0644-9. DOI: https://doi.org/10.1186/s12891-015-0644-9

Swanik CB, Lephart SM, Rubash HE. Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg Am. 2004;86:328–34. doi: 10.2106/00004623-200402000-00016. DOI: https://doi.org/10.2106/00004623-200402000-00016

Downloads

Published

2023-09-04

Issue

Section

Research Article

How to Cite

1.
Genç AS, Güzel N, Yaran M, Agar A, Eseoğlu İsmail, Anıl B, Korkmaz E, Akdemir E, Kesikbaş G, Yılmaz AK, Kehribar L. Investigation of mid-term functional skills and psychological factors in female patients undergoing total knee arthroplasty: Functional skills after total knee arthroplasty. J Surg Med [Internet]. 2023 Sep. 4 [cited 2024 Dec. 22];7(9):524-30. Available from: https://jsurgmed.com/article/view/7876