Background
People today are living longer and want to remain active. While obesity is becoming an epidemic, the number of patients suffering from osteoarthritis (OA) is expected to grow exponentially in the coming decades. Patients with OA of the knee are progressively being restricted in their activities. Since a knee arthroplasty (KA) is a well accepted, cost-effective intervention to relieve pain, restore function and improve health-related quality of life, indications are expanding to younger and more active patients. However, evidence concerning return to sports (RTS) and physical activity (PA) after KA is sparse.

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Return to Sports and Physical Activity After Total and Unicondylar Knee Arthroplasty: A Systematic Review and Meta-Analysis

The aims of this thesis were to investigate activities after knee arthroplasty (KA) and realignment osteotomies, younger knee OA patients’ expectations and activity goals, and to search for individualized ways to -realistically- improve satisfaction for activities of daily life, work and leisure time after KA. Conclusions: 1. Younger patients expect different activities to perform better after KA, that varied most in leisure time activities. 2. Return to both low- and higher-impact sports is possible after both Total KA (TKA) and Unicondylar KA (UKA), but seemed more likely after UKA than after TKA. 3. We found better outcomes for KA in anteromedial osteoarthritis (AMOA), compared to more advanced OA and other wear patterns, and this was slightly more likely if treated with UKA than with KA. 4. Patients can also return to sports activities and work after realignment osteotomies, also when they are young and athletic, and more likely than after KA. 5. Concerning ‘usual care’ rehabilitation after KA broad agreement amongst physiotherapists exists about goals for rehabilitation, but they use a variety of strategies to achieve those goals. 6. We described the intervention group of our ACTION trial, that followed rehabilitation using Goal Attainment Scaling (GAS) after KA. We showed that patients wished to achieve many activity goals, but that following six months of rehabilitation with GAS, almost all activity goals (91%) were attained; 7. Moreover, GAS-based rehabilitation after KA led to significant improvement of satisfaction for activities to Visual Analogue Scales of 80/100 at six months after surgery.

/pdf/improving-activities-and-satisfaction-of-younger-2fxiwt3xsb.pdf

Improving activities and satisfaction of younger osteoarthritis patients after knee arthroplasty and osteotomy: A patient tailored approach

Total joint replacement and tibial osteotomies have been used for decades to return the individual to activities and relieve pain. According to the American Academy of Orthopaedic Surgeons, joint replacement is considered one of the most successful medical innovations of the 20th century. Hip and knee-replacement operations are increasing in frequency and are continuing to achieve pain relief and improve function for patients with arthritic joints. Demand for knee replacement is expected to double over the next five to 10 years and for hip replacement, it is expected to double over the next 10 to 15 years. The trend for joint replacement has begun to include the younger as well as the older still active individual. Younger patients are considering joint-replacement surgery earlier in life due to advances in surgery and devices. Since children begin sports at a fairly early age, once they reach young adulthood, their joints have sustained recurrent internal impact for many years leading to degeneration earlier in life. These younger patients are expecting and choosing to participate in sports even after surgery. They want to be able to coach and play sports with their children without pain. While pain relief has historically been the main reason people have joint replacement surgery--the need to improve joint-function has also become motivating for patients--especially those involved in athletic activities. Patients and orthopedic surgeons do not necessarily worry about the same things after joint-replacement surgery.

Returning to sports after total joint replacements and tibial osteotomies: is it possible?

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Returning to sports after total joint replacements and tibial osteotomies: is it possible?