Does high activity after total and unicompartmental knee arthroplasty increase the risk for aseptic revision?

Streck, Laura E; Hanreich, Carola; Cororaton, Agnes D; Boettner, Cosima S; Boettner, Friedrich (2023). Does high activity after total and unicompartmental knee arthroplasty increase the risk for aseptic revision? (In Press). Archives of orthopaedic and trauma surgery Springer 10.1007/s00402-023-04794-1

[img] Text
s00402-023-04794-1.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.
Author holds Copyright

Download (528kB) | Request a copy

INTRODUCTION

It has been suggested that high activity might negatively impact implant survival following total and unicompartmental knee arthroplasty (TKA/UKA) and many surgeons advise their patients to only participate in moderate level sport activities. To date, it remains unclear whether such restraints are necessary to assure longevity of the implants.

MATERIALS AND METHODS

We conducted a retrospective study on 1906 knees (1745 TKA, 161 UKA) in 1636 patients aged 45-75 years who underwent primary arthroplasty for primary osteoarthritis. Lower extremity activity scale (LEAS) at a two year follow-up was assessed to define the activity level. Cases were grouped in low (LEAS ≤ 6), moderate (LEAS 7-13) and high activity (LEAS ≥ 14). Cohorts were compared with Kruskal-Wallis- or Pearson-Chi2-Test. Univariate logistic regression was conducted to test for association between activity level at two years and later revisions. Odds ratio was reported and converted to predicted probability. A Kaplan-Meier curve was plotted to predict implant survival.

RESULTS

The predicted implant survival for UKA was 100.0% at two years and 98.1% at five years. The predicted implant survival for TKA was 99.8% at two years, 98.1% at five years. The difference was not significant (p = 0.410). 2.5% of the UKA underwent revision, one knee in the low and three knees in the moderate activity group, differences between the moderate and high activity group were not significant (p = 0.292). The revision rate in the high activity TKA group was lower than in the low and moderate activity groups (p = 0.008). A higher LEAS two years after surgery was associated with a lower risk for future revision (p = 0.001). A one-point increase in LEAS two years after surgery lowered the odds for undergoing revision surgery by 19%.

CONCLUSIONS

The study suggests that participating in sports activity following both UKA and TKA is safe and not a risk factor for revision surgery at a mid-term follow-up. Patients should not be prevented from an active lifestyle following knee replacement.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Hanreich, Carola Anna

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1434-3916

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

08 Mar 2023 11:10

Last Modified:

08 Mar 2023 23:28

Publisher DOI:

10.1007/s00402-023-04794-1

PubMed ID:

36881148

Uncontrolled Keywords:

Activity Implant survival Knee arthroplasty Longevity Lower extremity activity scale Revision

BORIS DOI:

10.48350/179672

URI:

https://boris.unibe.ch/id/eprint/179672

Actions (login required)

Edit item Edit item
Provide Feedback