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Abstracts Presented at the 7th Biennial Congress of the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine| Volume 28, ISSUE 9, SUPPLEMENT , e340-e341, September 01, 2012

Paper 11: Which Patients Can Expect to play Sports After Total Knee Arthroplasty?

      Abstract

      Introduction

      Traditional goals such as pain relief are no longer the only expectations surgeons have, when performing modern arthroplasty. An increasing group of patients want to have an active sporting and professional life. They do not want to be restricted by their biological age. So as the goalposts are shifting surgeons need a way by which we can help predict realistically which patients can expect to play sports.

      Method

      This is a prospective cohort study of 150 patients.
      Patients were recruited from Jan 2001 till June 2003.
      Pre operative data was:
      1. clinical and radiological International Knee Score(IKS)
      2. Sports activity questionnaire
      3. Patient Expectations
      4. Patient Clinical Data (Eg:BMI, Operative technique)
      5. full radiological data including long standing axes, Merchant views etc
      The average follow up was 3.5 years
      The follow up period for the study included 3 months, 6 months then yearly.
      Standard post op review obtained the following information:
      1. Clinical Examination and complete radiological data
      2. IKS
      3. VAS Pain
      4. Post op sporting questionaire
      5. LEAS(Lower Extremity Ambulatory Score)

      Results

      M:
      F -45%:55%
      Average age 70
      BMI 28.5
      Pre-operatively 45 patients/ 150 wished to return to sport if possible
      All these 45 patients returned to sport post operatively.
      The average LEAS was Level 11 -2
      The sports played by these people were: (some people had more than one sport activity)
      1. golf(18),
      2. mountain hiking(21),
      3. bike riding(12),
      4. downhill skiing(19),
      5. tennis(7),
      6. gymnastque(19),
      7. windsurfing(4),
      8. rollerblading(2)
      9. karate(2),
      10. parasailing (1)
      In our study the factors that had significant high predictive value of returning to sport were the following.
      1. Preoperative desire to return to sport
      2. BMI <28 vs >33(non sport group)
      3. Males > Females
      The data that had no influence on the ability to play sport were
      1. Pre op IKS - Average 44 (sport group = non sport group)
      2. Post op IKS (97(sport) vs 93(non sport))
      3. Pre-op range of flexion (120 deg)
      4. Post op range of Flexion(128deg)
      4. neither pre op VAS(8.2/10) nor postOp VAS (0.45/10)
      5. The stage of arthritis
      6. Patella resurfacing
      7. Subvastus vs medial parapatellar
      40% of the 45 did more than one sporting activity. 45% of 45 performed sporting activities >2/week. The average time to return to sport was 6 months.
      The were no radiolucent lines, no wear nor effusions in the sporting group.

      Conclusion

      This study demonstrates that patients who express a desire to return to sports have the highest chance of being able to do so.
      Neither the severity of preoperative pain, preoperative range of flexion, the preoperative IKS score or the preoperative stage of arthritis were not significative limiting factors to the return to sports . Other factors are also predictive and should be used with more caution as these are not independent variables.
      There were no complications due to the sport activities in this patient group at this follow up in comparison with the non sport patient group.