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Does knee instability relate to pain and function following total knee arthroplasty?
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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632
levels of risk perception, which in turn may lead to increased levels of intention to exercise. Pre-operatively identifying people who have low levels of physical activity or low task self-efficacy and guiding them in action and coping plans may lead to increased levels of physical activity post-operatively. Keywords: Health action process approach; Physical activity; Knee arthroplasty Funding acknowledgements: This research was funded by Physiotherapy New Zealand and the Faculty of Health and Environmental Science, AUT University. Ethics approval: Ethical approval was obtained from Ministry of Health Regional Ethics committee reference NTX/12/EXP/124 and Auckland University of Technology Ethics Committee. http://dx.doi.org/10.1016/j.physio.2015.03.3339 Research Report Poster Presentation Number: RR-PO-14-08-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 DOES KNEE INSTABILITY RELATE TO PAIN AND FUNCTION FOLLOWING TOTAL KNEE ARTHROPLASTY? A. Alnagmoosh 1,2 , A. Harmer 1 , M. van der Esch 3 , M. Simic 1 , M. Fransen 1 1 The
University of Sydney, Physiotherapy, Sydney, Australia; 2 The University of Dammam, Physiotherapy, Dammam, Saudi Arabia; 3 University of Applied Sciences, Physiotherapy, Amsterdam, Netherlands Background: The relationship between self-reported knee instability and reported pain and activity limitations has been examined among people with knee osteoarthritis and community-dwelling older people, but not among people who have recently undergone total knee arthroplasty (TKA). It is unknown whether knee instability is relieved by surgery or whether the non-operated knee retains or develops instability. Purpose: To determine the relationship between selfreported knee instability (KI) at 6 months (T1) and self-reported pain and activity limitation at 12 months (T2) following TKA for osteoarthritis. Change in knee instability scores over time will also be explored. Methods: Study participants were asked to complete a knee instability questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function subscales for their operated and nonoperated knees at T1 and T2 following TKA. The knee instability questionnaire asks if the participant has experienced any episodes of buckling (full giving way) or slipping (partial giving way) during the last 3 months. To detect knee instability change over time, a cross tabulation feature was used. Spearman or Pearson correlations between knee instability and WOMAC pain and function scores at T1 and T2
were performed using SPSS (v 20,Chicago, IL). Significance level was accepted at p < 0.05. Results: Fifty-four patients with TKA participated in the study at T1 following TKA. At T2, the number decreased to 47 (87%): 22 women, mean ± SD age 66 ± 6 years, BMI 30.9 ± 5.8 kg/m2 . A total of 41 (87%) underwent unilateral TKA, 6 (13%) underwent simultaneous bilateral TKA. At T1 in the operated knee, a total of 85.1% of participants reported no KI, whereas 14.9% of the participants reported KI. At T2 in the operated knee, a total of 80.9% of the participants reported no KI while 19.1% reported KI. Results for KI in the non-operated knee were similar to the operated knee. Self-reported knee instability of the operated knee at T1 was significantly associated with WOMAC-pain (r = 0.47; p < 0.01) and physical function (r = 0.45; p < 0.01) of the operated knee at T2. Similarly, knee instability of the non-operated knee was related to WOMAC-pain (r = 0.34; p < 0.05) and physical function (r = 0.38; p < 0.01) of the nonoperated knee at T2. Conclusion(s): A year after a TKA, almost 20% of the participants still perceive knee instability of the operated knee. Knee instability at T1 is related to pain and function at T2 after a TKA. Implications: This study demonstrates that knee instability is persistent in a subgroup of patients after TKA. Knee instability is related to pain and function one year after knee surgery, and therefore should be addressed during rehabilitation, with the aim of improving pain and physical function longer-term. Keywords: Total knee arthroplasty; Knee stability; Pain Funding acknowledgements: There is no funding required for this study. Ethics approval: Ethical approval was granted by the University of Sydney Research Ethics Committee (2012/842). http://dx.doi.org/10.1016/j.physio.2015.03.3340 Research Report Poster Presentation Number: RR-PO-14-11-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 PHYSICAL ACTIVITY LEVELS DETERMINED BY ACCELEROMETER IN PATIENTS AT 6 MONTHS FOLLOWING TOTAL KNEE ARTHROPLASTY A. Alnagmoosh 1,2 , A. Harmer 1 , M. Simic 1 , M. Fransen 1 1 The
University of Sydney, Physiotherapy, Sydney, Australia; 2 University of Dammam, Physiotherapy, Dammam, Saudi Arabia Background: Knee pain in severe osteoarthritis may limit physical activity prior to total knee arthroplasty (TKA).
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632
levels of risk perception, which in turn may lead to increased levels of intention to exercise. Pre-operatively identifying people who have low levels of physical activity or low task self-efficacy and guiding them in action and coping plans may lead to increased levels of physical activity post-operatively. Keywords: Health action process approach; Physical activity; Knee arthroplasty Funding acknowledgements: This research was funded by Physiotherapy New Zealand and the Faculty of Health and Environmental Science, AUT University. Ethics approval: Ethical approval was obtained from Ministry of Health Regional Ethics committee reference NTX/12/EXP/124 and Auckland University of Technology Ethics Committee. http://dx.doi.org/10.1016/j.physio.2015.03.3339 Research Report Poster Presentation Number: RR-PO-14-08-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 DOES KNEE INSTABILITY RELATE TO PAIN AND FUNCTION FOLLOWING TOTAL KNEE ARTHROPLASTY? A. Alnagmoosh 1,2 , A. Harmer 1 , M. van der Esch 3 , M. Simic 1 , M. Fransen 1 1 The
University of Sydney, Physiotherapy, Sydney, Australia; 2 The University of Dammam, Physiotherapy, Dammam, Saudi Arabia; 3 University of Applied Sciences, Physiotherapy, Amsterdam, Netherlands Background: The relationship between self-reported knee instability and reported pain and activity limitations has been examined among people with knee osteoarthritis and community-dwelling older people, but not among people who have recently undergone total knee arthroplasty (TKA). It is unknown whether knee instability is relieved by surgery or whether the non-operated knee retains or develops instability. Purpose: To determine the relationship between selfreported knee instability (KI) at 6 months (T1) and self-reported pain and activity limitation at 12 months (T2) following TKA for osteoarthritis. Change in knee instability scores over time will also be explored. Methods: Study participants were asked to complete a knee instability questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function subscales for their operated and nonoperated knees at T1 and T2 following TKA. The knee instability questionnaire asks if the participant has experienced any episodes of buckling (full giving way) or slipping (partial giving way) during the last 3 months. To detect knee instability change over time, a cross tabulation feature was used. Spearman or Pearson correlations between knee instability and WOMAC pain and function scores at T1 and T2
were performed using SPSS (v 20,Chicago, IL). Significance level was accepted at p < 0.05. Results: Fifty-four patients with TKA participated in the study at T1 following TKA. At T2, the number decreased to 47 (87%): 22 women, mean ± SD age 66 ± 6 years, BMI 30.9 ± 5.8 kg/m2 . A total of 41 (87%) underwent unilateral TKA, 6 (13%) underwent simultaneous bilateral TKA. At T1 in the operated knee, a total of 85.1% of participants reported no KI, whereas 14.9% of the participants reported KI. At T2 in the operated knee, a total of 80.9% of the participants reported no KI while 19.1% reported KI. Results for KI in the non-operated knee were similar to the operated knee. Self-reported knee instability of the operated knee at T1 was significantly associated with WOMAC-pain (r = 0.47; p < 0.01) and physical function (r = 0.45; p < 0.01) of the operated knee at T2. Similarly, knee instability of the non-operated knee was related to WOMAC-pain (r = 0.34; p < 0.05) and physical function (r = 0.38; p < 0.01) of the nonoperated knee at T2. Conclusion(s): A year after a TKA, almost 20% of the participants still perceive knee instability of the operated knee. Knee instability at T1 is related to pain and function at T2 after a TKA. Implications: This study demonstrates that knee instability is persistent in a subgroup of patients after TKA. Knee instability is related to pain and function one year after knee surgery, and therefore should be addressed during rehabilitation, with the aim of improving pain and physical function longer-term. Keywords: Total knee arthroplasty; Knee stability; Pain Funding acknowledgements: There is no funding required for this study. Ethics approval: Ethical approval was granted by the University of Sydney Research Ethics Committee (2012/842). http://dx.doi.org/10.1016/j.physio.2015.03.3340 Research Report Poster Presentation Number: RR-PO-14-11-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 PHYSICAL ACTIVITY LEVELS DETERMINED BY ACCELEROMETER IN PATIENTS AT 6 MONTHS FOLLOWING TOTAL KNEE ARTHROPLASTY A. Alnagmoosh 1,2 , A. Harmer 1 , M. Simic 1 , M. Fransen 1 1 The
University of Sydney, Physiotherapy, Sydney, Australia; 2 University of Dammam, Physiotherapy, Dammam, Saudi Arabia Background: Knee pain in severe osteoarthritis may limit physical activity prior to total knee arthroplasty (TKA).