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- DOI: 10.2522/ptj.20130109
- PMID: 23813082
- UKPMCID: 23813082
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Participation Following Knee Replacement: The MOST Cohort Study.
Maxwell, Jessica L; Keysor, Julie J; Niu, Jingbo; Singh, Jasvinder A; Wise, Barton L; Frey-Law, Laura; Nevitt, Michael C; Felson, David T
Physical therapy. 2013;93(11):1467-1474.
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Full-text held externally
- DOI: 10.2522/ptj.20130109
- PMID: 23813082
- UKPMCID: 23813082
Abstract
INTRODUCTION: Participation is an important, yet little studied, post- total knee replacement (TKR) outcome. We investigated the extent and predictors of participation and participation restriction among people after TKR. MATERIALS AND METHODS: We studied the change in pain, function, and participation scores (measured using a subscale of the Late Life Function and Disability Instrument from pre-TKR to ≥1 year post-TKR among a subsample of subjects from the MOST longitudinal cohort. We calculated the proportions of subjects with participation restriction pre-TKR and ≥ 1 and ≥ 2 years post-TKR for all subjects and for important demographic subgroups. We estimated the association between demographic and clinical factors and participation using linear regression, and with participation restriction using logistic regression. RESULTS: There were 292 subjects with outcome data ≥ 1 year post-TKR. Of these, 218 subjects (75%) had data pre- and ≥ 1 year post-TKR, and 160 (55%) ≥ 2 years. There were mean improvements in pain, function, and participation at ≥ 1 and 2 years. However, approximately 30% of subjects had participation restriction pre- and post- TKR, and the proportion only decreased significantly for those < 65 years old (p<0.01). Non-Whites had a higher proportion of participation restriction than any other subgroup (41% ≥1 year, 48% ≥2 years). Female sex (p<0.01) and non-White race (p=0.05) were associated with a worse participation score, and several demographic and modifiable factors were associated with having participation restriction following TKR. CONCLUSIONS: Although there was a mean increase in participation ≥ 1 year following TKR, participation restriction was common. The likelihood of low participation was increased among women, non-Whites, those with depressive symptoms, severe pain in either knee or worse pre-TKR function.