Comparison of pain, functional and psychological trajectories between total and unicompartmental knee arthroplasties : secondary analysis of a 6-month prospective observational study
Terradas-Monllor, Marc (Universitat de Vic)
Rierola-Fochs, Sandra (Universitat de Vic)
Merchán-Baeza, Jose Antonio (Universitat de Vic)
Parés, Carles (Universitat de Vic)
Font-Jutglà, Cristina (Universitat de Vic)
Hernández-Hermoso, José A. (Universitat Autònoma de Barcelona. Departament de Medicina)
Ochandorena-Acha, Mirari (Universitat de Vic)

Date:	2024
Abstract:	Unicompartmental knee arthroplasty (UKA) treats osteoarthritis in one knee compartment, while total knee arthroplasty (TKA) addresses all compartments. The debate focuses on UKA's advantages of quicker recovery and fewer complications versus TKA's lower long-term revision rates, emphasizing the need for thorough outcome evaluations. The aim of the present study is to describe and compare the pain, functional and psychological trajectories during a 6-month postoperative rehabilitation period between total and unicompartmental knee arthroplasties. 115 participants who had undergone either TKA or UKA were recruited. Outcome measurements were performed at 1, 4, 12 and 24 weeks post-surgery. Measurements included pain intensity (Visual Analog Scale), range of motion, walking speed (4 m walking test), physical performance (30-s chair stand test), health functioning (Western Ontario and McMaster Universities Osteoarthritis Index), pain catastrophizing (pain catastrophizing scale), fear of movement (Tampa Scale of Kinesiophobia), anxiety and depression (Hospital Anxiety and Depression Scale). A mixed-effects model was used to estimate the influence of type of surgery (either unicompartmental or total knee arthroplasty) to pain, function, and psychological trajectories. Both TKA and UKA groups showed significant improvements across the six-month rehabilitation period except for anxiety symptoms in the TKA group, and fear of movement and depression in the UKA group. Between group analysis revealed that in the acute phase UKA patients showed improved range of motion and TKA patients displayed faster walking speed but higher fear of movement. Overall, the type of surgery does not significantly influence the overall rehabilitation pain, functional and psychological trajectories. Despite differences in the acute phase, there are no differences in pain, functional and psychological trajectories throughout the six-month rehabilitation period. These results should be acknowledged to better inform patients and to improve patient education during the perioperative period. NCT03378440 (2017-12-18), retrospectively registered. Level II.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Total knee arthroplasty ; Unicompartmental knee arthroplasty ; Knee replacement ; Postsurgical pain
Published in:	Archives of orthopaedic and trauma surgery, Vol. 145 (december 2024) , ISSN 1434-3916

DOI: 10.1007/s00402-024-05710-x
PMID: 39666075

9 p, 652.6 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles