Influence of Comorbidities on Short-term Functional Outcomes after Unilateral Total Knee Arthroplasty

Youn Ji Kim, Bo Ryun Kim, Sang Rim Kim, Kwang Woo Nam, So Young Lee, Jun Hwan Choi, Won Bin Kim, Beom Su Kim
American Journal of Physical Medicine & Rehabilitation 2021 January 19

OBJECTIVE: To determine the effect of comorbidities on physical function and quality of life (QoL) of patients at 3-months after total knee arthroplasty (TKA).

DESIGN: Data from 140 patients who underwent a primary unilateral TKA were examined retrospectively. Comorbidities were osteoporosis, presarcopenia, degenerative spine disease, diabetes, and hypertension. All patients completed the following: range of motion (ROM), stair climbing test (SCT), 6-minute walk test (6MWT), timed up-and-go test (TUG), peak torque (PT) of the knee extensor and flexor, instrumental gait analysis, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and EuroQoL five dimensions (EQ-5D) questionnaire.

RESULTS: Univariate analyses revealed that osteoporosis led to a significantly longer time to complete the SCT-ascent, SCT-descent, and TUG, and to lower scores for the 6MWT and PT of the knee extensor. Patients with degenerative spine disease showed significant negative scores for knee extension ROM. Diabetes showed a negative correlation with PT of the knee extensor and knee flexion ROM, and a higher WOMAC-stiffness score. Multivariable linear regression analysis showed that WOMAC-stiffness remained independently associated with diabetes. 6MWT, TUG, and SCT-ascent. PT of the knee extensors showed a significant association with osteoporosis.

CONCLUSION: Comorbidities, particularly osteoporosis and diabetes, affect short-term functional outcomes 3 months after TKA.

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