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Minerva Orthopedics 2022 February;73(1):76-84

DOI: 10.23736/S2784-8469.20.04076-X


lingua: Inglese

The real results of total knee arthroplasty in moderate-to-severe osteoarthritis: a 1-year cohort study

André F. CANELAS 1 , Paulo C. ARAÚJO 1, Raquel P. FONSECA 2, José B. FERREIRA 1, Simão E. SERRANO 1, Maria L. LUÍS 1, Filipa S. JANUÁRIO 1, Ana M. BÁRTOLO 1

1 Department of Physical and Rehabilitation Medicine, Hospital Center of Leiria, Leiria, Portugal; 2 Department of Anaesthesiology, Hospital Center of Leiria, Leiria, Portugal

BACKGROUND: As the average age of the population increases and the access to health care system improves, an exponential growth in the number of primary total knee arthroplasties (TKA) is expected, as well as in their clinical and economic burden. The aim of this study was to assess the long-term outcome after a rehabilitation program for Total Knee Arthroplasty (TKA) and prognostic factors concerning pain, other associated symptoms, functionality and quality of life (QoL).
METHODS: Cohort study including patients who underwent TKA followed by a rehabilitation program. The patients were evaluated before and 2 days, 3 and 12 months after TKA. Several clinical and socio-demographic variables, the Hospital Anxiety and Depression Scale, the numerical pain rating scale (NPRS), Knee injury and Osteoarthritis Outcome Score (KOOS) and Short Form Health Survey (SF-36) were assessed throughout the study.
RESULTS: A total of 72 patients were included, 61% female, mean age of 71 years old. There was a significant improvement throughout the study in NPRS, in all KOOS subscales and in most of SF-36 domains. Nearly 20% of patients were not satisfied with the results. Prevalence of NPRS≥4 was 33% and 30% at 3 and 12 months, respectively. The female sex, previous anxiety levels, intensity of the knee pain before the intervention and the presence of poorly controlled postoperative pain predicted chronic pain development.
CONCLUSIONS: TKA followed by a specific rehabilitation program significantly improves symptoms, functionality and QoL. Chronic pain is a major concern and can explain lower satisfaction rates.

KEY WORDS: Arthroplasty, replacement, knee; Osteoarthritis; Rehabilitation; Chronic pain

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