Self-reported knee instability associated with pain, activity limitations, and poorer quality of life before and 1 year after total knee arthroplasty in patients with knee osteoarthritis.

Autor: Leichtenberg CS; Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands., Vliet Vlieland TPM; Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands., Kroon HM; Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands., Dekker J; VU University Medical Centre, Department of Rehabilitation Medicine, Amsterdam, the Netherlands.; VU University Medical Centre, Department of Psychiatry, Amsterdam, the Netherlands., Marijnissen WJ; Albert Schweitzer Hospital, Department of Orthopaedics, Dordrecht, the Netherlands., Damen PJ; Waterland Hospital, Department of Orthopaedics, Purmerend, the Netherlands., Nelissen RGHH; Department of Orthopaedics, Leiden University Medical Centre, Leiden, the Netherlands., van der Esch M; Amsterdam Rehabilitation Research Centre/Reade, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2018 Oct; Vol. 36 (10), pp. 2671-2678. Date of Electronic Publication: 2018 May 24.
DOI: 10.1002/jor.24023
Abstrakt: Information on the association of self-reported knee instability with clinical outcomes after Total Knee Arthroplasty (TKA) and 1 year follow-up is scarce. The aims were to determine (i) the course and prevalence of self-reported knee instability before and 1 year after TKA and (ii) the associations of preoperative, postoperative, and retained self-reported knee instability with pain, activity limitations, and quality of life (QoL) in patients with knee osteoarthritis. Patients undergoing primary TKA, selected from the Longitudinal Leiden Orthopaedics and Outcomes of OsteoArthritis Study, had their knee instability measured using a questionnaire. The Knee injury and Osteoarthritis Outcome Score pain, activity limitations, and QoL subscales were administered before and 1 year after surgery. Multivariable regression analyses were performed to examine associations between knee instability, pain, activity limitations, and QoL, adjusted for covariates (age, gender, comorbidities, and radiographic severity). Of the 908 included patients, 649 (71%) and 187 (21%) reported knee instability before and following TKA, respectively. Of the patients with preoperative knee instability, this perception was retained in 165 (25%) cases. Knee instability was preoperatively associated with pain (B -9.6; 95%CI: -12.4 to -6.7), activity limitations (B -7.5; 95%CI: -10.2 to -4.8), and QoL (B -4.7; 95%CI: -7.0 to -2.4) and postoperatively with pain (B -15.0; 95%CI: -18.5 to -11.6), activity limitations (B -15.1; 95%CI: -18.4 to -11.8), and QoL (B -18.7; 95%CI: -22.3 to -15.3). Retained knee instability was associated with postoperative pain (B -15.1; 95%CI: -18.9 to -11.2), activity limitations (B -14.1; 95%CI: -17.8 to -10.4), and QoL (B -18.0; 95%CI: -21.7 to -14.3). In conclusion, in clinical care, self-reported knee instability is retained postoperatively in 25% of the patients. Retained knee instability is associated with more pain, activity limitations, and poorer QoL postoperatively. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2671-2678, 2018.
(© 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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