Paul W Stratford1, Deborah M Kennedy, Susan F Robarts. 1. Paul W. Stratford, PT, MSc: Professor, School of Rehabilitation Science; Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Abstract
PURPOSE: To model change in knee range of motion (ROM) post total knee arthroplasty (TKA) and to show how this information can be incorporated into clinical decision making. METHOD: We applied a variable-occasion repeated-measures study design. Patients' knee flexion and extension ROM were assessed pre- and post arthroplasty over the ensuing 60 weeks. We examined change in ROM post TKA using linear and nonlinear mixed-effects modelling, and examined whether age, body mass index, prearthroplasty ROM, and gender were determinants of recovery in post-arthroplasty ROM. RESULTS: Of 93 eligible patients, 74 provided pre- and post-arthroplasty data. A random intercept nonlinear model fit the flexion data best, and a random intercept linear model fit the extension data best. Pre-arthroplasty ROM was found to be a determinant of recovery in ROM post arthroplasty. This finding was common to both flexion and extension models. CONCLUSIONS: Our study showed that the greatest improvement for knee ROM took place during the first 12 weeks post arthroplasty. Of the variables examined, only pre-arthroplasty ROM was a determinant of outcome (p<0.05). The study results provide clinicians with data to determine expected rates of improvement for patients as well as the projected maximum ROM, facilitating improved clinical decision making.
PURPOSE: To model change in knee range of motion (ROM) post total knee arthroplasty (TKA) and to show how this information can be incorporated into clinical decision making. METHOD: We applied a variable-occasion repeated-measures study design. Patients' knee flexion and extension ROM were assessed pre- and post arthroplasty over the ensuing 60 weeks. We examined change in ROM post TKA using linear and nonlinear mixed-effects modelling, and examined whether age, body mass index, prearthroplasty ROM, and gender were determinants of recovery in post-arthroplasty ROM. RESULTS: Of 93 eligible patients, 74 provided pre- and post-arthroplasty data. A random intercept nonlinear model fit the flexion data best, and a random intercept linear model fit the extension data best. Pre-arthroplasty ROM was found to be a determinant of recovery in ROM post arthroplasty. This finding was common to both flexion and extension models. CONCLUSIONS: Our study showed that the greatest improvement for knee ROM took place during the first 12 weeks post arthroplasty. Of the variables examined, only pre-arthroplasty ROM was a determinant of outcome (p<0.05). The study results provide clinicians with data to determine expected rates of improvement for patients as well as the projected maximum ROM, facilitating improved clinical decision making.
Authors: Thorsten M Seyler; David R Marker; Anil Bhave; Johannes F Plate; German A Marulanda; Peter M Bonutti; Ronald E Delanois; Michael A Mont Journal: J Bone Joint Surg Am Date: 2007-10 Impact factor: 5.284
Authors: Deborah M Kennedy; Paul W Stratford; Jean Wessel; Jeffrey D Gollish; Dianne Penney Journal: BMC Musculoskelet Disord Date: 2005-01-28 Impact factor: 2.362
Authors: Karen L Barker; Jon Room; Ruth Knight; Susan J Dutton; Fran Toye; Jose Leal; Seamus Kent; Nicola Kenealy; Michael M Schussel; Gary Collins; David J Beard; Andrew Price; Martin Underwood; Avril Drummond; Elaine Cook; Sarah E Lamb Journal: Health Technol Assess Date: 2020-11 Impact factor: 4.014