Background/Purpose: "Osteoarthritis (OA) of the hips and knees is estimated to be the fourth leading cause of functional disability world-wide,"(1) Total knee arthroplasty (TKA) is the leading surgery to treat chronic knee pain secondary to OA, and "is the most commonly performed musculoskeletal procedure in the United States."(1, 3) The purpose of this case study was to identify which outcome measures can best predict postoperative function following a TKA. The PICO question asked: In adults with OA, who undergo TKA, do better preoperative functional outcomes predict better functional outcomes postoperatively at 6 weeks, compared to those who did not perform as well? Case Description: Mr. L, a 77-year-old-male who was admitted to the hospital for a left TKA to address significant left knee OA. He was seen in the hospital for three sessions of acute physical therapy before being discharged home with a referral to outpatient physical therapy. Upon his discharge Mr. L had left knee range of motion (ROM) of 4-91 degrees and six weeks post TKA his range improved to 2 - 122 degrees. Outcomes: Included were ROM, Timed Up and Go (TUG), Six Minute Walk Test (6MWT), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Discussion: Although most of the articles analyzed found that preoperative functional outcome measures predict how well a patient may do following a TKA, more research is necessary to fully understand the best measures to use and if they can predict the full potential of recovery. Despite the lack of significant prediction rules, the PICO question has been answered. In adults with OA, who underwent TKA, better preoperative performances on the TUG, 6MWT, ROM, and WOMAC could predict better functional outcomes postoperatively. What makes this information even more significant to physical therapists, especially those in an acute-care setting is that preoperative and acute functional performance measures can be included when assessing patient needs for discharge and can allow better patient education and expectation management for an overall more successful rehabilitation experience.
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Arthroplasty, Replacement, Knee; Articular Range of Motion, Outcome Assessment (Health Care)
Rice, Leah. "Do Pre-operative Functional Measures Predict Post-operative Function In Adults Undergoing TKA?." (2016). http://digitalrepository.unm.edu/dpt/6