Significant improvement in locomotive functions after total knee arthroplasty but worse than those of independent ambulatory community dwellers

Abstract

Purpose: This study investigated the adequacy of improvements in locomotive syndrome (LS) and other clinical outcomes after total knee arthroplasty (TKA) for medial knee osteoarthritis. Methods: A total of 74 patients who underwent unilateral primary TKA were evaluated pre-operatively and 3, 6, and 12 months post-TKA using the 25-question Geriatric Locomotive Function Scale (GLFS-25) to evaluate the severity of LS, the Japanese Knee Osteoarthritis Measure (JKOM), the Knee Society Score (KSS), the timed up and go (TUG) test, and range of motion of the knee joint (ROM). The GLFS-25 score and the severity of LS were compared between these patients and independent ambulatory community dwellers (273 males and 477 females). Results: The GLFS-25, JKOM, KSS, TUG scores, and ROM significantly improved post-operatively. The pre-operative incidence of LS stage 3, indicating the worst locomotive function, decreased from 81.1% to 24.3% at the final follow-up. However, the median (interquartile range) GLFS-25 score of 13 (6–23) seemed much worse, and the incidence of LS stage 3 of 24.3% seemed much higher even 12 months post-TKA compared with independent ambulatory community dwellers. Conclusions: The GLFS-25 score and other clinical outcome scales significantly improved after TKA. However, improvements in locomotive functions were not adequate as approximately 25% of patients remained with LS stage 3. Besides ordinary rehabilitation programmes after TKA, some interventions, such as more rigorous muscle exercises, would be necessary to obtain greater improvements in LS.

Keywords

• Healthy aging
• Locomotive syndrome
• Mobility impairment
• Osteoarthritis
• Superaged society
• Total knee arthroplasty