TY - JOUR
T1 - Kneeling and standing up from a chair as performance-based tests to evaluate knee function in the high-flexion range
T2 - A randomized controlled trial comparing a conventional and a high-flexion TKA design
AU - Van Der Ven, Paul J.P.
AU - van de Groes, Sebastiaan
AU - Zelle, Jorrit
AU - Koëter, Sander
AU - Hannink, Gerjon
AU - Verdonschot, Nico
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background: We compared the functional outcome between conventional and high-flexion total knee arthroplasty (TKA) using kneeling and sit-to-stand tests at 1 year post-operative. In addition, the patient's daily functioning, pain and satisfaction were quantified using questionnaires. Methods: We randomly assigned 56 patients to receive either a conventional or a high-flexion TKA. Primary outcomes were maximum flexion angle and maximum thigh-calf contact measured during kneeling at 1 year post operatively. Secondary outcomes were the angular knee velocity and ground reaction force ratio measured during sit-to-stand performance tests, and questionnaires. Results: At one year post-operative, maximum knee flexion during kneeling was higher for the high-flexion TKA group (median 128.02° (range 108-146)) compared to the conventional TKA group (119.13° (range 72-135)) (p = 0.03). Maximum thigh-calf contact force was higher for the high flexion TKA group (median 17.82 N (range 2.98-114.64)) compared to the conventional TKA group (median 9.37 N (range 0.33-46.58))(p = 0.04). The sit-to-stand tests showed a significantly higher angular knee velocity in the conventional TKA group (12.12 rad/s (95%CI 0.34-23.91); p = 0.04). There were no significant differences between groups in ground reaction force ratios and patient-reported outcome scores. Conclusion: Although no differences were found in patient-reported outcome scores, differences in performance-based tests were clearly apparent. Standing up from a chair at 90° of knee flexion appeared to be easier for the conventional group. The kneeling test revealed significantly higher weight-bearing knee flexion for the high-flex group. Hence, if kneeling is an important activity for a patient a high-flex design may be recommendable. Trial registration: The study was retrospectively registered in ClinicalTrials.gov under identifier NCT00899041 (date of registration: May 11, 2009).
AB - Background: We compared the functional outcome between conventional and high-flexion total knee arthroplasty (TKA) using kneeling and sit-to-stand tests at 1 year post-operative. In addition, the patient's daily functioning, pain and satisfaction were quantified using questionnaires. Methods: We randomly assigned 56 patients to receive either a conventional or a high-flexion TKA. Primary outcomes were maximum flexion angle and maximum thigh-calf contact measured during kneeling at 1 year post operatively. Secondary outcomes were the angular knee velocity and ground reaction force ratio measured during sit-to-stand performance tests, and questionnaires. Results: At one year post-operative, maximum knee flexion during kneeling was higher for the high-flexion TKA group (median 128.02° (range 108-146)) compared to the conventional TKA group (119.13° (range 72-135)) (p = 0.03). Maximum thigh-calf contact force was higher for the high flexion TKA group (median 17.82 N (range 2.98-114.64)) compared to the conventional TKA group (median 9.37 N (range 0.33-46.58))(p = 0.04). The sit-to-stand tests showed a significantly higher angular knee velocity in the conventional TKA group (12.12 rad/s (95%CI 0.34-23.91); p = 0.04). There were no significant differences between groups in ground reaction force ratios and patient-reported outcome scores. Conclusion: Although no differences were found in patient-reported outcome scores, differences in performance-based tests were clearly apparent. Standing up from a chair at 90° of knee flexion appeared to be easier for the conventional group. The kneeling test revealed significantly higher weight-bearing knee flexion for the high-flex group. Hence, if kneeling is an important activity for a patient a high-flex design may be recommendable. Trial registration: The study was retrospectively registered in ClinicalTrials.gov under identifier NCT00899041 (date of registration: May 11, 2009).
KW - Functional outcome
KW - High-flexion
KW - Kneeling
KW - Performance-based tests
KW - Sit-to-stand
KW - Total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85026505994&partnerID=8YFLogxK
U2 - 10.1186/s12891-017-1657-3
DO - 10.1186/s12891-017-1657-3
M3 - Article
AN - SCOPUS:85026505994
SN - 1471-2474
VL - 18
JO - BMC musculoskeletal disorders
JF - BMC musculoskeletal disorders
IS - 1
M1 - 324
ER -