|Beitragstitel||Do patients increase sports and leisure time physical activity after total joint replacement? A prospective evaluation|
Aim of the study was 1) to determine levels of sports and activity participation within the year before total joint replacement (TJR) and within the year after TJR, 2) to assess preoperative expectations regarding sports/leisure time activities, and 3) to analyze any effects of expectations and activity levels on the 1-year outcome of TJR based on patient-reported outcome measure (PROM) values and satisfaction rates.
This prospective study included 380 patients with osteoarthritis undergoing THA (n=193) or TKA (n=187). The patients completed different PROMs (Oxford Scores, WOMAC, EQ-5D, UCLA activity scale) before and at 12 months after TJR. An additional questionnaire inquired for the participation in different activities and sports within the last 12 months before (baseline) and after surgery (follow-up). At baseline, the patients also stated if they expect to participate in the different activities after surgery and if they consider participation in any specific activity as important. At follow-up, the patients rated their overall satisfaction with the result of surgery.
Overall, 86.6% of the patients were active at least occasionally before surgery and 87.4% were so at follow-up. There were no differences between THA and TKA patients. Active patients indicated participation in a mean of 4.7 different activities before surgery and in 4.0 at 12 months after TJR (P <0.01). The most frequent activities before and after surgery were hiking, swimming, cycling, fitness training, gymnastics and downhill skiing. Only 7 mainly low-impact activities were rated as important by more than 20% of the patients, another six disciplines were positively rated by 10-20%. Patients who were regularly active had significantly higher score values on most PROMs than their inactive counterparts. There were no differences between regularly active and inactive patients for overall satisfaction (93.8% versus 94.6% satisfied or very satisfied).
Almost 90% of patients undergoing TJR were physically active in the year before surgery, and the same large proportion was active postoperatively. There were no substantial differences between THA and TKA patients except a trend towards engagement in more activities with higher impact in the hip group. Expectations were almost exclusively linked to activities with lower impact. Regularly sports-active patients had higher PROM values than their inactive counterparts, but activity-participation was not correlated with overall satisfaction.