Kahn Timothy L, Schwarzkopf Ran
University of California Irvine Medical Center, Orange, CA, USA.
Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Medical Center Hospital For Joint Diseases, New York, NY, USA.
Geriatr Orthop Surg Rehabil. 2016 Sep;7(3):142-7. doi: 10.1177/2151458516654518. Epub 2016 Jun 20.
Despite the alleviation of osteoarthritis (OA) symptoms that total knee arthroplasty (TKA) provides for patients with end-stage knee OA, recent studies have suggested that TKA may not increase physical activity levels. In this study, we compare the physical activity levels of patients with OA treated nonoperatively (non-TKA) with both patients who had received TKA (post-TKA) and patients who received TKA within 3 years of data collection (pre-TKA).
Utilizing the Osteoarthritis Initiative database, accelerometry data were collected from non-TKA, pre-TKA, and post-TKA patients. Accelerometry data were subdivided by physical activity intensity levels, yielding daily minutes of each level of activity. Physical activity levels were then compared between non-TKA and pre-TKA/post-TKA patients. Physical activity levels for each patient were also compared to the Department of Health and Human Services (DHHS) guidelines for physical activity.
There was no difference in physical activity between non-TKA and pre-TKA patients, with the exception of non-TKA patients achieving more daily minutes of vigorous activity (P < .001). There was no difference in physical activity between non-TKA and post-TKA patients. Although 11.6% of non-TKA patients met DHHS guidelines, only 4.8% of pre-TKA and 5.3% of post-TKA patients met guidelines.
Despite the improvements in patient-reported outcome measures following TKA, we found that TKA alone does not improve physical activity levels beyond those seen in the average patient with OA. In our study, the vast majority of patients with OA, treated nonoperatively or operatively, did not meet current DHHS guidelines for physical activity.
尽管全膝关节置换术(TKA)为终末期膝骨关节炎(OA)患者缓解了症状,但最近的研究表明,TKA可能不会提高身体活动水平。在本研究中,我们比较了非手术治疗OA患者(非TKA)与接受TKA患者(TKA术后)以及在数据收集3年内接受TKA患者(TKA术前)的身体活动水平。
利用骨关节炎倡议数据库,收集非TKA、TKA术前和TKA术后患者的加速度计数据。加速度计数据按身体活动强度水平细分,得出每个活动水平的每日分钟数。然后比较非TKA与TKA术前/TKA术后患者的身体活动水平。还将每位患者的身体活动水平与美国卫生与公众服务部(DHHS)的身体活动指南进行比较。
非TKA与TKA术前患者的身体活动无差异,但非TKA患者的剧烈活动每日分钟数更多(P <.001)。非TKA与TKA术后患者的身体活动无差异。虽然11.6%的非TKA患者符合DHHS指南,但只有4.8%的TKA术前患者和5.3%的TKA术后患者符合指南。
尽管TKA后患者报告的结局指标有所改善,但我们发现,仅TKA并不能提高身体活动水平,使其超过普通OA患者。在我们的研究中,绝大多数接受非手术或手术治疗的OA患者未达到当前DHHS的身体活动指南。