Knee Arthroplasty Patients Predicted versus Actual Recovery: What are their expectations about time of recovery following surgery and how long before they can do the tasks they want to do?
Barker KL., Hannink E., Pemberton S., Jenkins C.
OBJECTIVE: (1) To determine evidence-based guidance for the length of time to return to specific valued functional and leisure activities following knee arthroplasty (KA). (2) To determine what patients feel are the most important functional or leisure activities to recover after KA. (3) To collect information about patients' expectations and compare them to the actual time it takes to return. DESIGN: Prospective longitudinal cohort observational survey SETTING: Specialist orthopaedic hospital PARTICIPANTS: 99 patients with osteoarthritis or rheumatoid arthritis (mean= 69.9 years old [range 44-88]) listed for Total Knee Arthroplasty (TKA) or Unicompartmental Knee Arthroplasty (UKA) INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: Valued Activity List (VAL) used to select activities patients expect to return to and report the actual time taken to return. RESULTS: Participants in UKA group returned to the six most popular valued activities (walking >1km, stairs, housework, driving, gardening and kneeling) 8-33% more quickly than TKA group, and they were satisfied with performing these activities sooner on average (4-18%) than the TKA group. The percentage of participants satisfied at 12 months post-surgery ranged from 96% returning to housework to 36% returning to kneeling. Wilcoxon signed-ranks tests comparing expected time and actual time to return: housework (Z=-5.631, p<0.05, effect size=0.64) and swimming (Z=-3.209, p<0.05, effect size=0.59) was quicker than expected and walking > 1km (Z=-2.324, p<0.05, effect size=0.27) was slower than expected. CONCLUSIONS: A more tailored and personalised approach with consideration of prior level of activity and comorbidities must be taken into account and adequately discussed in order to help bridge the gap between expected and actual recovery time.