Balance and quality of life after total knee arthroplasty

Fernandes, Daniel Araujo; Poeta, Lisiane Schilling; Martins, Cesar Antônio de Quadros; Lima, Fernando de; Rosa Neto, Francisco

doi:10.1016/j.rboe.2017.07.013

Brasil

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Artigos Originais • Rev. bras. ortop. 53 (6) • Nov-Dec 2018 • https://doi.org/10.1016/j.rboe.2017.07.013 linkcopy

Balance and quality of life after total knee arthroplasty^☆

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To evaluate the change in balance and quality of life in patients undergoing total knee arthroplasty for primary gonarthrosis.

Method: Patients aged 60 years or older were evaluated in relation to the balance and quality of life before total knee arthroplasty and six months after surgery. To assess balance, this study used the Motor Scale Test for the Elderly; quality of life was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and the Short Form Health Survey. A control group consisting of healthy adults, age- and gender-paired, was used to compare the balance after surgery results.

Results: Twenty-eight patients completed the study, of a total of 37 arthroplasties. The mean age was 70.18 ± 6.17 years. All variables were statistically significant (p ≤ 0.05) for improved balance and quality of life after arthroplasty. It was observed that, after knee arthroplasty, the level of balance does not reach that expected for healthy individuals (p ≤ 0.05).

Conclusion: Total knee arthroplasty is effective at improving balance six months after surgery, as well as all domains of quality of life. However, it is not able to restore balance to a level comparable to that of healthy individuals.

Keywords: Total knee replacement; Balance; Elderly; Osteoarthritis; Quality of life

Variables	Cases (n = 28)	Control (n = 44)	p-Value
	Mean^a a Standard deviation.	Mean^a a Standard deviation.
Age (years)	70.18 (6.17)	70.43 (6.20)	0.880
Height (m)	1.62 (0.11)	1.63 (0.05)	0.650
Mass (kg)	80.92 (15.63)	73.75 (9.99)	0.050
BMI (kg/m²)	30.60 (4.48)	27.59 (3.05)	0.060^b b Significant difference (Student's t-test).

Variables	Frequency	%
Joint
Knee
Unilateral	19	67.9
Bilateral	09	32.1
Total	28	100

Schooling
1-4 years	19	82.6
5-8 years	01	3.6
9-11 years	02	7.1
>11 years	01	3.6
Total	23	100

Age group
60-74 years	20	71.4
≥75 years	08	28.6
Total	28	100

Gender
Male	7	25
Female	21	75
Total	28	100

Scale	n	Median Preop [IQ]	Median Postop [IQ]	Z	p-Value	r
WOMAC (4-0)
Pain	28	3.10 [1.70]	0 [0.35]	-4.628	0.000^a a Significant difference (Wilcoxon's test).	0.618
Rigidity	28	3.50 [2.00]	0 [0.5]	-4.658	0.000^a a Significant difference (Wilcoxon's test).	0.622
Physical function	28	3.10 [1.47]	0.17 [0.22]	-4.623	0.000^a a Significant difference (Wilcoxon's test).	0.618

SF-36 (0-100)
FC	28	5.00 [13.80]	70.00 [25.00]	-4.629	0.000^a a Significant difference (Wilcoxon's test).	0.618
LPA	28	0 [0]	100 [25.00]	-4.778	0.000^a a Significant difference (Wilcoxon's test).	0.638
Pain	28	12.00 [22.00]	72.00 [39.00]	-4.627	0.000^a a Significant difference (Wilcoxon's test).	0.618
GHS	28	87.00 [15.00]	92.00 [5.00]	-2.397	0.017^a a Significant difference (Wilcoxon's test).	0.320
Vit	27	80.00 [40.00]	90.00 [5.00]	-3.223	0.001^a a Significant difference (Wilcoxon's test).	0.438
SA	27	0 [37.50]	100 [0]	-4.467	0.000^a a Significant difference (Wilcoxon's test).	0.607
LEA	28	100 [100]	100 [0]	-3.843	0.003^a a Significant difference (Wilcoxon's test).	0.513
MH	27	72.00 [36]	92.00 [20.00]	-3.820	0.000^a a Significant difference (Wilcoxon's test).	0.519
PCo	27	20.70 [8.70]	49.50 [12.60]	-4.469	0.000^a a Significant difference (Wilcoxon's test).	0.608
MCo	27	55.60 [20.60]	63.40 [5.60]	-3.051	0.004^a a Significant difference (Wilcoxon's test).	0.415

VAS (10-0)
Pain	28	10.00 [1.00]	1.00 [3.00]	-4.639	0.000^a a Significant difference (Wilcoxon's test).	0.620

MSTE (0-132)
Balance	28	24.00 (24.00)	60.00 [24.00]	-3.674	0.000^a a Significant difference (Wilcoxon's test).	0.491

Variable		Groups		p-Value	Z	Effect size (r)
		Patients	Control
		(n = 28)
Balance	Median [IQ]	60.0 [24.0]	84.0 [45.0]	<0.003^a a Significant difference (Mann-Whitney U-test).	-2.959	0.395
	Range	24.0-96.0	24.0-132.0

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Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[TFN1] ^a
Standard deviation.

[TFN2] ^b
Significant difference (Student's t-test).

[TFN3] n, sample size.

Balance and quality of life after total knee arthroplasty☆

ABSTRACT

Balance and quality of life after total knee arthroplasty^☆