Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched study

Abstract Purpose To evaluate the effects of total knee arthroplasty (TKA) on symptoms, function and activity over 5 years in knee osteoarthritis (KOA) patients. Methods Data were from the Osteoarthritis Initiative (OAI). Participants who conducted the first TKA from (not before) enrolment to 48 mont...

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Main Authors: Liru Ge, Junjie Wang, Haonan Fang, Yining Wang, Ziyuan Shen, Guoqi Cai
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1002/jeo2.70185
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author Liru Ge
Junjie Wang
Haonan Fang
Yining Wang
Ziyuan Shen
Guoqi Cai
author_facet Liru Ge
Junjie Wang
Haonan Fang
Yining Wang
Ziyuan Shen
Guoqi Cai
author_sort Liru Ge
collection DOAJ
description Abstract Purpose To evaluate the effects of total knee arthroplasty (TKA) on symptoms, function and activity over 5 years in knee osteoarthritis (KOA) patients. Methods Data were from the Osteoarthritis Initiative (OAI). Participants who conducted the first TKA from (not before) enrolment to 48 months were propensity score matching (PSM) on their characteristics at the visit before surgery (treated as baseline) to those who did not conduct a TKA at 48 months (treated as baseline). Changes in knee pain and functional disability were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function subscales. Changes in physical activity, physical function and overall physical health and mental health were assessed using the Physical Activity Scale for the Elderly, the 20‐m walk speed and the five times chair‐to‐stand tests and the 12‐Item Short Form Survey, respectively. Results Eighty‐two pairs of participants in the TKA (56% women, mean 64.8 ± 8.4 years) and non‐TKA groups were matched. Knee symptoms were significantly improved in the TKA group and flatted from 24 months (Pain: β = −3.29, 95% confidence interval [CI] = [−4.59 to −1.99], p < 0.001; Function: β = −10.12, 95% CI = [−14.21 to −6.03], p < 0.001). Physical function and overall physical health but not physical activity or mental health (PASE: β = 5.72, 95% CI = [−15.46 to 26.90], p = 0.597; Mental: β = 0.04, 95% CI = [−2.47 to 2.54], p = 0.976) was improved in the TKA group over 24 months. Conclusions TKA substantially improved knee symptoms and physical function over 60 months and physical health over 48 months, compared to those who had a similar severity of KOA but did not have a TKA, but this did not translate into increased physical activity or mental health. Level of Evidence Level III.
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spelling doaj-art-ff81059f0c7a432182ab35cec0c5d8af2025-08-20T02:26:06ZengWileyJournal of Experimental Orthopaedics2197-11532025-01-01121n/an/a10.1002/jeo2.70185Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched studyLiru Ge0Junjie Wang1Haonan Fang2Yining Wang3Ziyuan Shen4Guoqi Cai5Department of Epidemiology and Biostatistics, School of Public Health Anhui Medical University Hefei Anhui ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Anhui Medical University Hefei Anhui ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Anhui Medical University Hefei Anhui ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Anhui Medical University Hefei Anhui ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Anhui Medical University Hefei Anhui ChinaDepartment of Epidemiology and Biostatistics, School of Public Health Anhui Medical University Hefei Anhui ChinaAbstract Purpose To evaluate the effects of total knee arthroplasty (TKA) on symptoms, function and activity over 5 years in knee osteoarthritis (KOA) patients. Methods Data were from the Osteoarthritis Initiative (OAI). Participants who conducted the first TKA from (not before) enrolment to 48 months were propensity score matching (PSM) on their characteristics at the visit before surgery (treated as baseline) to those who did not conduct a TKA at 48 months (treated as baseline). Changes in knee pain and functional disability were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function subscales. Changes in physical activity, physical function and overall physical health and mental health were assessed using the Physical Activity Scale for the Elderly, the 20‐m walk speed and the five times chair‐to‐stand tests and the 12‐Item Short Form Survey, respectively. Results Eighty‐two pairs of participants in the TKA (56% women, mean 64.8 ± 8.4 years) and non‐TKA groups were matched. Knee symptoms were significantly improved in the TKA group and flatted from 24 months (Pain: β = −3.29, 95% confidence interval [CI] = [−4.59 to −1.99], p < 0.001; Function: β = −10.12, 95% CI = [−14.21 to −6.03], p < 0.001). Physical function and overall physical health but not physical activity or mental health (PASE: β = 5.72, 95% CI = [−15.46 to 26.90], p = 0.597; Mental: β = 0.04, 95% CI = [−2.47 to 2.54], p = 0.976) was improved in the TKA group over 24 months. Conclusions TKA substantially improved knee symptoms and physical function over 60 months and physical health over 48 months, compared to those who had a similar severity of KOA but did not have a TKA, but this did not translate into increased physical activity or mental health. Level of Evidence Level III.https://doi.org/10.1002/jeo2.70185osteoarthritispainphysical activityphysical functiontotal knee replacement
spellingShingle Liru Ge
Junjie Wang
Haonan Fang
Yining Wang
Ziyuan Shen
Guoqi Cai
Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched study
Journal of Experimental Orthopaedics
osteoarthritis
pain
physical activity
physical function
total knee replacement
title Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched study
title_full Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched study
title_fullStr Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched study
title_full_unstemmed Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched study
title_short Effects of total knee arthroplasty on symptoms, function and activity over 5 years in knee osteoarthritis: A propensity‐score matched study
title_sort effects of total knee arthroplasty on symptoms function and activity over 5 years in knee osteoarthritis a propensity score matched study
topic osteoarthritis
pain
physical activity
physical function
total knee replacement
url https://doi.org/10.1002/jeo2.70185
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