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The Chitranjan Ranawat Award: functional outcome after total knee replacement varies with patient attributes
Orthopedics and Physical Rehabilitation Publications and Presentations
  • Patricia D. Franklin, University of Massachusetts Medical School
  • Wenjun Li, University of Massachusetts Medical School
  • David C. Ayers, University of Massachusetts Medical School
UMMS Affiliation
Department of Orthopedics and Physical Rehabilitation; Clinical and Population Health Research Program; Department of Medicine, Division of Preventive and Behavioral Medicine
Date
11-1-2008
Document Type
Article
Medical Subject Headings
Aged; Aged, 80 and over; Arthralgia; Arthroplasty, Replacement, Knee; Awards and Prizes; Body Mass Index; Disability Evaluation; Female; Follow-Up Studies; Humans; Male; Orthopedics; Osteoarthritis, Knee; Pain Measurement; Range of Motion, Articular; Retrospective Studies; Societies, Medical; Time Factors; Treatment Outcome; Walking
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.

Rights and Permissions
Citation: Clin Orthop Relat Res. 2008 Nov;466(11):2597-604. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
18810570
Citation Information
Patricia D. Franklin, Wenjun Li and David C. Ayers. "The Chitranjan Ranawat Award: functional outcome after total knee replacement varies with patient attributes" Vol. 466 Iss. 11 (2008) ISSN: 0009-921X (Linking)
Available at: http://works.bepress.com/franklinp/19/