The Chitranjan Ranawat Award: functional outcome after total knee replacement varies with patient attributes
dc.contributor.author | Franklin, Patricia D | |
dc.contributor.author | Li, Wenjun | |
dc.contributor.author | Ayers, David C. | |
dc.date | 2022-08-11T08:10:08.000 | |
dc.date.accessioned | 2022-08-23T16:56:52Z | |
dc.date.available | 2022-08-23T16:56:52Z | |
dc.date.issued | 2008-11-01 | |
dc.date.submitted | 2010-02-17 | |
dc.identifier.citation | Clin Orthop Relat Res. 2008 Nov;466(11):2597-604. <a href="http://dx.doi.org/10.1007/s11999-008-0428-8">Link to article on publisher's site</a> | |
dc.identifier.issn | 0009-921X (Linking) | |
dc.identifier.doi | 10.1007/s11999-008-0428-8 | |
dc.identifier.pmid | 18810570 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/43022 | |
dc.description.abstract | Total knee replacement effectively relieves arthritis pain but improvement in physical function varies. A clearer understanding of the patient attributes associated with differing levels of functional gain after TKR is critical to surgical decision making. We reviewed 8050 primary, unilateral TKR patients enrolled in a prospective registry between 2000 and 2005 who had complete data. We evaluated associations between 12-month function (SF12/PCS) and preoperative gender, age, BMI, emotional health (MCS), knee diagnosis, quadriceps strength, and physical function (PCS). More than 98% of patients reported pain relief (KS pain score). At 12 months, mean PCS gain was 13.6 points, but the distribution was bimodal. The mean gain in PCS in the 63% of patients with greater improvement was 21 (SD = 7), and 4.1 (SD = 7) in the remaining 37%. Increased likelihood of poor functional gain was associated with older age, body mass index (BMI) over 40, lower MCS, and poor quadriceps strength. While two-thirds of patients reported functional gain well above national average at 12 months post-TKR, 37% reported limited functional improvement. Further understanding of the patient attributes associated with limited improvement will guide the design of innovative strategies to improve functional outcomes. LEVEL OF EVIDENCE: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=18810570&dopt=Abstract">Link to Article in PubMed</a> | |
dc.relation.url | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565049/ | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Arthralgia | |
dc.subject | Arthroplasty, Replacement, Knee | |
dc.subject | Awards and Prizes | |
dc.subject | Body Mass Index | |
dc.subject | Disability Evaluation | |
dc.subject | Female | |
dc.subject | Follow-Up Studies | |
dc.subject | Humans | |
dc.subject | Male | |
dc.subject | Orthopedics | |
dc.subject | Osteoarthritis, Knee | |
dc.subject | Pain Measurement | |
dc.subject | Range of Motion, Articular | |
dc.subject | Retrospective Studies | |
dc.subject | Societies, Medical | |
dc.subject | Time Factors | |
dc.subject | Treatment Outcome | |
dc.subject | Walking | |
dc.subject | Orthopedics | |
dc.subject | Rehabilitation and Therapy | |
dc.title | The Chitranjan Ranawat Award: functional outcome after total knee replacement varies with patient attributes | |
dc.type | Journal Article | |
dc.source.journaltitle | Clinical orthopaedics and related research | |
dc.source.volume | 466 | |
dc.source.issue | 11 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/ortho_pp/3 | |
dc.identifier.contextkey | 1150379 | |
html.description.abstract | <p>Total knee replacement effectively relieves arthritis pain but improvement in physical function varies. A clearer understanding of the patient attributes associated with differing levels of functional gain after TKR is critical to surgical decision making. We reviewed 8050 primary, unilateral TKR patients enrolled in a prospective registry between 2000 and 2005 who had complete data. We evaluated associations between 12-month function (SF12/PCS) and preoperative gender, age, BMI, emotional health (MCS), knee diagnosis, quadriceps strength, and physical function (PCS). More than 98% of patients reported pain relief (KS pain score). At 12 months, mean PCS gain was 13.6 points, but the distribution was bimodal. The mean gain in PCS in the 63% of patients with greater improvement was 21 (SD = 7), and 4.1 (SD = 7) in the remaining 37%. Increased likelihood of poor functional gain was associated with older age, body mass index (BMI) over 40, lower MCS, and poor quadriceps strength. While two-thirds of patients reported functional gain well above national average at 12 months post-TKR, 37% reported limited functional improvement. Further understanding of the patient attributes associated with limited improvement will guide the design of innovative strategies to improve functional outcomes. LEVEL OF EVIDENCE: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.</p> | |
dc.identifier.submissionpath | ortho_pp/3 | |
dc.contributor.department | Department of Medicine, Division of Preventive and Behavioral Medicine | |
dc.contributor.department | Clinical and Population Health Research Program | |
dc.contributor.department | Department of Orthopedics and Physical Rehabilitation | |
dc.source.pages | 2597-604 |