Research Article
BibTex RIS Cite

The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty

Year 2025, Volume: 9 Issue: 2, 374 - 381, 31.05.2025
https://doi.org/10.30621/jbachs.1603848

Abstract

References

  • Klug A, Gramlich Y, Rudert M, Drees P, Hoffmann R, Weißenberger M, et al. The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years. Knee Surg Sports Traumatol Arthrosc 2021;29(10):3287-98.
  • Omar I, Kunutsor SK, Bertram W, Moore AJ, Blom AW, Lenguerrand E, Whitehouse MR, Wylde V. Rehabilitation for revision total knee replacement: survey of current service provision and systematic review. BMC Musculoskelet Disord 2023;24(1):91.
  • James Lind Alliance Priority Setting Partnership [Internet 2020]. Revision Knee Replacement Top 10 Priorities. [Accessed date: 22 July 2024]. Available from: https://www.jla.nihr.ac.uk/priority-setting-partnerships/Revision-knee-replacement/revision-knee-replacementtop-10-priorities.htm.
  • Ghomrawi HM, Kane RL, Eberly LE, Bershadsky B, Saleh KJ. Patterns of functional improvement after revision knee arthroplasty. J Bone Joint Surg Am 2009;91(12):2838-45.
  • Petersen KK, Simonsen O, Laursen MB, Nielsen TA, Rasmussen S, Arendt-Nielsen L. Chronic postoperative pain after primary and revision total knee arthroplasty. Clin J Pain 2015;31(1):1-6.
  • Della Valle CJ, Berger RA, Rosenberg AG. Surgical exposures in revision total knee arthroplasty. Clin Orthop Relat Res 2006;446:59-68.
  • Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L. Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol, Avon) 2008;23(3):320-8.
  • Kasmire KE, Rasouli MR, Mortazavi SM, Sharkey PF, Parvizi J. Predictors of functional outcome after revision total knee arthroplasty following aseptic failure. Knee 2014;21(1):264-7.
  • Stevens-Lapsley JE, Schenkman ML, Dayton MR. Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. Pmr 2011;3(6):541-9.
  • Gandhi R, Tsvetkov D, Davey JR, Syed KA, Mahomed NN. Relationship between self-reported and performance-based tests in a hip and knee joint replacement population. Clin Rheumatol 2009;28(3):253-7.
  • Sabah SA, Hedge EA, Abram SGF, Alvand A, Price AJ, Hopewell S. Patient-reported outcome measures following revision knee replacement: a review of PROM instrument utilisation and measurement properties using the COSMIN checklist. BMJ Open 2021;11(10):e046169.
  • Mizner RL, Petterson SC, Clements KE, Zeni JA, Jr., Irrgang JJ, Snyder-Mackler L. Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplasty 2011;26(5):728-37.
  • Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39(2):175-91.
  • Narin S, Unver B, Bakırhan S, Bozan O, Karatosun V. Cross-cultural adaptation, reliability and validity of the Turkish version of the Hospital for Special Surgery (HSS) Knee Score. Acta Orthop Traumatol Turc 2014;48(3):241-8.
  • Yuksel E, Kalkan S, Cekmece S, Unver B, Karatosun V. Assessing Minimal Detectable Changes and Test-Retest Reliability of the Timed Up and Go Test and the 2-Minute Walk Test in Patients With Total Knee Arthroplasty J Arthroplasty 2017;32(2):426-30.
  • Unver B, Kalkan S, Yuksel E, Kahraman T, Karatosun V. Reliability of the 50-foot walk test and 30-sec chair stand test in total knee arthroplasty. Acta Ortop Bras 2015;23(4):184-7.
  • Eymir M, Unver B, Karatosun V. Reliability, Concurrent Validity, and Minimal Detectable Change of the Hand-Held Dynamometry for the Assessment of Knee Muscle Strength in Patients With Revision Total Knee Arthroplasty. Arch Phys Med Rehabil 2024;105(1):34-9.
  • Schober P, Boer C, Schwarte LA. Correlation Coefficients: Appropriate Use and Interpretation. Anesth Analg 2018;126(5):1763-8.
  • Brown K, Kachelman J, Topp R, Quesada PM, Nyland J, Malkani A, et al. Predictors of functional task performance among patients scheduled for total knee arthroplasty. J Strength Cond Res 2009;23(2):436-43.
  • Kennedy D, Stratford PW, Pagura SM, Walsh M, Woodhouse LJ. Comparison of gender and group differences in self-report and physical performance measures in total hip and knee arthroplasty candidates. J Arthroplasty 2002;17(1):70-7.
  • Skoffer B, Dalgas U, Mechlenburg I, Søballe K, Maribo T. Functional performance is associated with both knee extensor and flexor muscle strength in patients scheduled for total knee arthroplasty: A cross-sectional study. J Rehabil Med 2015;47(5):454-9.
  • Yuksel E, Eymir M, Unver B, Karatosun V. Reliability, concurrent validity and minimal detectable change of the L test in patients with total knee arthroplasty. Disabil Rehabil 2022;44(14):3714-8.
  • Boonstra MC, De Waal Malefijt MC, Verdonschot N. How to quantify knee function after total knee arthroplasty? Knee 2008;15(5):390-5.
  • Zhamilov V, Karatosun V, Kalkan S, Unver B, Gunal I. Evaluation of Extensor Mechanism in Revision Knee Arthroplasty. J Arthroplasty 2017;32(8):2484-6.
  • Meier W, Mizner RL, Marcus RL, Dibble LE, Peters C, Lastayo PC. Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. J Orthop Sports Phys Ther 2008;38(5):246-56.
  • Eymir M, Unver B, Karatosun V. Relaxation exercise therapy improves pain, muscle strength, and kinesiophobia following total knee arthroplasty in the short term: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2022;30(8):2776-85.
  • Riddle DL, Wade JB, Jiranek WA, Kong X. Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clin Orthop Relat Res 2010;468(3):798-806.

The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty

Year 2025, Volume: 9 Issue: 2, 374 - 381, 31.05.2025
https://doi.org/10.30621/jbachs.1603848

Abstract

Purpose: To investigate the correlation between performance-based and patient-reported measures and their relation with knee muscle strength in the assessment of revision total knee arthroplasty (rTKA) patients.
Materials and Methods: This cross-sectional study recruited 92 patients with rTKA. The outcome assessment was performed using three performance tests and one patient-reported questionnaire. The maximum isometric muscle strength of knee flexors and knee extensors was assessed with Handheld Dynamometry (HHD).
Results: The total HSS knee score showed low significant associations with performance-based tests (all, p< 0.05), but no associations with knee muscles strength. The knee extensors strength showed moderate to strong significant associations with all performance tests, while the knee flexors strength had low to moderate significant correlation with these performance tests (all, p<0.05).
Conclusion: Our findings, which show a low correlation between performance-based tests and patient-reported questionnaire, suggest patient perception fails to accurately capture the functioning at the late follow-up of rTKA. Therefore, performance-based tests should be included in the outcome assessment to determine an appropriate rehabilitation program and exercise training after rTKA. Moreover, the higher associations between functional tests and knee muscle strength than the associations of the questionnaire with these performance measures advocate this assertion.

Ethical Statement

This study was approved by the Non-interventional Research Ethics Committee of Dokuz Eylul University (Date: 03.04.2019, Approval number: 2019/08-39).

References

  • Klug A, Gramlich Y, Rudert M, Drees P, Hoffmann R, Weißenberger M, et al. The projected volume of primary and revision total knee arthroplasty will place an immense burden on future health care systems over the next 30 years. Knee Surg Sports Traumatol Arthrosc 2021;29(10):3287-98.
  • Omar I, Kunutsor SK, Bertram W, Moore AJ, Blom AW, Lenguerrand E, Whitehouse MR, Wylde V. Rehabilitation for revision total knee replacement: survey of current service provision and systematic review. BMC Musculoskelet Disord 2023;24(1):91.
  • James Lind Alliance Priority Setting Partnership [Internet 2020]. Revision Knee Replacement Top 10 Priorities. [Accessed date: 22 July 2024]. Available from: https://www.jla.nihr.ac.uk/priority-setting-partnerships/Revision-knee-replacement/revision-knee-replacementtop-10-priorities.htm.
  • Ghomrawi HM, Kane RL, Eberly LE, Bershadsky B, Saleh KJ. Patterns of functional improvement after revision knee arthroplasty. J Bone Joint Surg Am 2009;91(12):2838-45.
  • Petersen KK, Simonsen O, Laursen MB, Nielsen TA, Rasmussen S, Arendt-Nielsen L. Chronic postoperative pain after primary and revision total knee arthroplasty. Clin J Pain 2015;31(1):1-6.
  • Della Valle CJ, Berger RA, Rosenberg AG. Surgical exposures in revision total knee arthroplasty. Clin Orthop Relat Res 2006;446:59-68.
  • Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L. Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol, Avon) 2008;23(3):320-8.
  • Kasmire KE, Rasouli MR, Mortazavi SM, Sharkey PF, Parvizi J. Predictors of functional outcome after revision total knee arthroplasty following aseptic failure. Knee 2014;21(1):264-7.
  • Stevens-Lapsley JE, Schenkman ML, Dayton MR. Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. Pmr 2011;3(6):541-9.
  • Gandhi R, Tsvetkov D, Davey JR, Syed KA, Mahomed NN. Relationship between self-reported and performance-based tests in a hip and knee joint replacement population. Clin Rheumatol 2009;28(3):253-7.
  • Sabah SA, Hedge EA, Abram SGF, Alvand A, Price AJ, Hopewell S. Patient-reported outcome measures following revision knee replacement: a review of PROM instrument utilisation and measurement properties using the COSMIN checklist. BMJ Open 2021;11(10):e046169.
  • Mizner RL, Petterson SC, Clements KE, Zeni JA, Jr., Irrgang JJ, Snyder-Mackler L. Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplasty 2011;26(5):728-37.
  • Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39(2):175-91.
  • Narin S, Unver B, Bakırhan S, Bozan O, Karatosun V. Cross-cultural adaptation, reliability and validity of the Turkish version of the Hospital for Special Surgery (HSS) Knee Score. Acta Orthop Traumatol Turc 2014;48(3):241-8.
  • Yuksel E, Kalkan S, Cekmece S, Unver B, Karatosun V. Assessing Minimal Detectable Changes and Test-Retest Reliability of the Timed Up and Go Test and the 2-Minute Walk Test in Patients With Total Knee Arthroplasty J Arthroplasty 2017;32(2):426-30.
  • Unver B, Kalkan S, Yuksel E, Kahraman T, Karatosun V. Reliability of the 50-foot walk test and 30-sec chair stand test in total knee arthroplasty. Acta Ortop Bras 2015;23(4):184-7.
  • Eymir M, Unver B, Karatosun V. Reliability, Concurrent Validity, and Minimal Detectable Change of the Hand-Held Dynamometry for the Assessment of Knee Muscle Strength in Patients With Revision Total Knee Arthroplasty. Arch Phys Med Rehabil 2024;105(1):34-9.
  • Schober P, Boer C, Schwarte LA. Correlation Coefficients: Appropriate Use and Interpretation. Anesth Analg 2018;126(5):1763-8.
  • Brown K, Kachelman J, Topp R, Quesada PM, Nyland J, Malkani A, et al. Predictors of functional task performance among patients scheduled for total knee arthroplasty. J Strength Cond Res 2009;23(2):436-43.
  • Kennedy D, Stratford PW, Pagura SM, Walsh M, Woodhouse LJ. Comparison of gender and group differences in self-report and physical performance measures in total hip and knee arthroplasty candidates. J Arthroplasty 2002;17(1):70-7.
  • Skoffer B, Dalgas U, Mechlenburg I, Søballe K, Maribo T. Functional performance is associated with both knee extensor and flexor muscle strength in patients scheduled for total knee arthroplasty: A cross-sectional study. J Rehabil Med 2015;47(5):454-9.
  • Yuksel E, Eymir M, Unver B, Karatosun V. Reliability, concurrent validity and minimal detectable change of the L test in patients with total knee arthroplasty. Disabil Rehabil 2022;44(14):3714-8.
  • Boonstra MC, De Waal Malefijt MC, Verdonschot N. How to quantify knee function after total knee arthroplasty? Knee 2008;15(5):390-5.
  • Zhamilov V, Karatosun V, Kalkan S, Unver B, Gunal I. Evaluation of Extensor Mechanism in Revision Knee Arthroplasty. J Arthroplasty 2017;32(8):2484-6.
  • Meier W, Mizner RL, Marcus RL, Dibble LE, Peters C, Lastayo PC. Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. J Orthop Sports Phys Ther 2008;38(5):246-56.
  • Eymir M, Unver B, Karatosun V. Relaxation exercise therapy improves pain, muscle strength, and kinesiophobia following total knee arthroplasty in the short term: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2022;30(8):2776-85.
  • Riddle DL, Wade JB, Jiranek WA, Kong X. Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clin Orthop Relat Res 2010;468(3):798-806.
There are 27 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Research Article
Authors

Musa Eymir 0000-0002-9671-9583

Bayram Ünver 0000-0002-9829-5884

Vasfi Karatosun 0000-0002-0385-4840

Publication Date May 31, 2025
Submission Date December 18, 2024
Acceptance Date April 27, 2025
Published in Issue Year 2025 Volume: 9 Issue: 2

Cite

APA Eymir, M., Ünver, B., & Karatosun, V. (2025). The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty. Journal of Basic and Clinical Health Sciences, 9(2), 374-381. https://doi.org/10.30621/jbachs.1603848
AMA Eymir M, Ünver B, Karatosun V. The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty. JBACHS. May 2025;9(2):374-381. doi:10.30621/jbachs.1603848
Chicago Eymir, Musa, Bayram Ünver, and Vasfi Karatosun. “The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty”. Journal of Basic and Clinical Health Sciences 9, no. 2 (May 2025): 374-81. https://doi.org/10.30621/jbachs.1603848.
EndNote Eymir M, Ünver B, Karatosun V (May 1, 2025) The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty. Journal of Basic and Clinical Health Sciences 9 2 374–381.
IEEE M. Eymir, B. Ünver, and V. Karatosun, “The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty”, JBACHS, vol. 9, no. 2, pp. 374–381, 2025, doi: 10.30621/jbachs.1603848.
ISNAD Eymir, Musa et al. “The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty”. Journal of Basic and Clinical Health Sciences 9/2 (May2025), 374-381. https://doi.org/10.30621/jbachs.1603848.
JAMA Eymir M, Ünver B, Karatosun V. The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty. JBACHS. 2025;9:374–381.
MLA Eymir, Musa et al. “The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty”. Journal of Basic and Clinical Health Sciences, vol. 9, no. 2, 2025, pp. 374-81, doi:10.30621/jbachs.1603848.
Vancouver Eymir M, Ünver B, Karatosun V. The Outcome Assessment Requires Both Performance-Based and Patient-Reported Measures After Revision Total Knee Arthroplasty. JBACHS. 2025;9(2):374-81.