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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2006

Open Access 01-12-2006 | Research article

Modeling early recovery of physical function following hip and knee arthroplasty

Authors: Deborah M Kennedy, Paul W Stratford, Steven E Hanna, Jean Wessel, Jeffrey D Gollish

Published in: BMC Musculoskeletal Disorders | Issue 1/2006

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Abstract

Background

Information on early recovery after arthroplasty is needed to help benchmark progress and make appropriate decisions concerning patient rehabilitation needs. The purpose of this study was to model early recovery of physical function in patients undergoing total hip (THA) and knee (TKA) arthroplasty, using physical performance and self-report measures.

Methods

A sample of convenience of 152 subjects completed testing, of which 69 (mean age: 66.77 ± 8.23 years) underwent THA and 83 (mean age: 60.25 ± 11.19 years) TKA. Postoperatively, patients were treated using standardized care pathways and rehabilitation protocols. Using a repeated measures design, patients were assessed at multiple time points over the first four postoperative months. Outcome measures included the Lower Extremity Function Scale (LEFS), the physical function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC PF), the 6 minute walk test (6 MWT), timed up and go test (TUG) and a timed stair test (ST). Average recovery curves for each of the measures were characterized using hierarchical linear modeling. Predictors of recovery were sequentially modeled after validation of the basic developmental models.

Results

Slopes of recovery were greater in the first 6 to 9 weeks with a second-degree polynomial growth term (weeks squared) providing a reasonable fit for the data over the study interval. Different patterns of recovery were observed between the self-report measures of physical function and the performance measures. In contrast to the models for the WOMAC PF and the LEFS, site of arthroplasty was a significant predictor (p = 0.001) in all of the physical performance measure models with the patients post TKA initially demonstrating higher function. Site of arthroplasty (p = 0.025) also predicted the rate of change for patients post THA and between 9 to 11 weeks after surgery, the THA group surpassed the function of the patients post TKA.

Conclusion

Knowledge about the predicted growth curves will assist clinicians in referencing patient progress, and determining the critical time points for measuring change. The study has contributed further evidence to highlight the benefit of using physical performance measures to learn about the patients' actual level of disability.
Appendix
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Metadata
Title
Modeling early recovery of physical function following hip and knee arthroplasty
Authors
Deborah M Kennedy
Paul W Stratford
Steven E Hanna
Jean Wessel
Jeffrey D Gollish
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2006
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-7-100

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