Functional Outcomes in High-function-demand Patients After Total Knee Arthroplasty

Lozano Calderón, Santiago A. MD, PhD
Shen, Jianhua MS
Doumato, Diana F. MS
Zelicof, Steven MD, PhD

Drs Lozano Calderón and Zelicof are from the Orthopaedic Surgery Department, Westchester Medical Center, New York Medical College, Valhalla, New York; and Mss Shen and Doumato are from Stryker Orthopaedics, Mahwah, New Jersey.

Dr Lozano Calderón has no relevant financial relationships to disclose. Mss Shen and Doumato are paid employees at Stryker Orthopaedics. Dr Zelicof is a paid consultant for, has received royalties of US <$10,000 from, and has received research funding from Stryker Orthopaedics.

Correspondence should be addressed to: Santiago A. Lozano Calderón, MD, PhD, Orthopaedic Surgery Department, Westchester Medical Center, New York Medical College, Macy Pavillion, Room 8, 95 Grasslands Rd, Valhalla, NY 10595 ( [email protected]).

Orthopedics 35(5):p e681-e690, May 01, 2012. | DOI: 10.3928/01477447-20120426-22

Total knee arthroplasty is a safe last-resort treatment for osteoarthritis that has excellent results in low-function-demand elderly patients. Current implants offer the same results in high-function-demand patients. However, supportive data do not exist.

One-year Krackow Activity Scores (KAS) of 552 patients from 2 prospective studies were used to retrospectively determine low- and high-function-demand populations. Low function demand was defined as a KAS between 1 and 9 points, and high function demand was defined as a KAS between 10 and 18 points. Patients were assessed preoperatively and at 6 weeks, 3 months, and 1 and 2 years postoperatively per the Knee Society Score-function domain, KAS, SF-36, range of motion, and pain. Comparability between groups was tested for demographics and comorbidities.

Both groups showed significant improvement in function, range of motion, and pain 2 years postoperatively. High-function-demand patients had comparable improvement in function compared with low-function-demand patients. Excellent function can be achieved in high-function-demand patients.