Article

The purpose of this study was to
investigate the extent and predictors of participation and participation
restriction among people after TKR. MATERIALS AND METHODS:
This study
investigated the changes in pain, function, and participation scores (measured
using a subscale of the Late-Life Function and Disability Instrument) from
pre-TKR to >/=1 year post-TKR among a subsample of participants from the
Multicenter Osteoarthritis Study (MOST) longitudinal cohort (MOST is funded by
the National Institutes of Health). The proportions of individuals with
participation restriction pre-TKR and >/=1 and >/=2 years post-TKR were
calculated for all participants and for important demographic subgroups. The
association between demographic and clinical factors and participation was
estimated using linear regression. The association between demographic and
clinical factors and participation restriction was estimated using logistic
regression. RESULTS: There were 292 individuals with outcome data >/=1 year
post-TKR. Of these, 218 (75%) had data pre-TKR and >/=1 year post-TKR and 160
(55%) had data >/=2 years post-TKR. There were mean improvements in pain,
function, and participation at >/=1 and 2 years. However, approximately 30% of
the study sample had participation restriction pre-TKR and post-TKR, and the
proportion decreased significantly only for those <65 years old. Non-whites had a
higher proportion of participation restriction than any other subgroup (41% >/=1
year, 48% >/=2 years). Female sex and non-white race were associated with a worse
participation score, and several demographic and modifiable factors were
associated with participation restriction following TKR. LIMITATIONS: The time
between pre-TKR and post-TKR assessment varied across study participants, and
data were not available on their rehabilitation utilization. CONCLUSIONS:
Although there was a mean increase in participation >/=1 year following TKR,
participation restriction was common. The likelihood of low participation was
increased among women, non-whites, and those with depressive symptoms, severe
pain in either knee, or worse pre-TKR function.

Langue : ANGLAIS