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Physical Activity and Risk of Revision Total Knee Arthroplasty in Individuals with Knee Osteoarthritis: A Matched Case-Control Study
DINA L. JONES, JANE A. CAULEY, ANDREA M. KRISKA, STEPHEN R. WISNIEWSKI, JAMES J. IRRGANG, DAVID A. HECK, C. KENT KWOH, and LAWRENCE S. CROSSETT
ABSTRACT.
Methods. This was a matched case-control study. The cases had primary TKA followed by revision arthroplasty. Controls had primary TKA and no revision arthroplasty. Cases and controls were matched for age, sex, number of knees replaced, and date of primary TKA. Standardized telephone interviews were conducted to assess historical leisure activity, occupational activity, and instrumental activities of daily living after primary TKA in metabolic equivalent (MET)-hours per week. Conditional logistic regression was performed to identify the variables that predicted the need for revision arthroplasty. Results. Seventeen female and 9 male pairs, aged 47 to 85 years, participated. Most of the reported activity was of low impact and low or moderate intensity. Cases reported a median of 44.5 (range 0 to 137) MET-hours of total historical physical activity per week compared with controls' 55.1 (range 0 to 278) MET-hours. Total historical physical activity was not associated with the risk of revision arthroplasty (OR 0.99, 95% CI 0.99–1.01). Participants with primary TKA (controls) consistently reported more MET-hours of leisure and occupational activity than those with revision arthroplasty (cases) regardless of the number of knees replaced or whether or not walking was accounted for. Conclusion. This study quantified and described patterns of physical activity in a population with TKA. Physical activity did not appear to be a risk factor for revision arthroplasty. Our results suggest that individuals undergoing primary TKA should be encouraged to remain active after surgery. (J Rheumatol 2004;31:1384-90) Key Indexing Terms:
PHYSICAL ACTIVITY
From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. Supported by the Arthritis Foundation and the Foundation for Physical Therapy. D.L. Jones, PhD, PT, Research Associate, Division of Rheumatology and Clinical Immunology, Department of Medicine, and Clinical Assistant Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences; J.A. Cauley, DrPH, MPH, Associate Professor; A.M. Kriska, PhD, Associate Professor; S.R. Wisniewski, PhD, Assistant Professor; J.J. Irrgang, PhD, PT, ATC, Assistant Professor, Vice-Chairman Clinical Services, Department of Physical Therapy, School of Health and Rehabilitation Sciences; D.A. Heck, MD, Professor, Department of Orthopaedic Surgery, Indiana University; C.K. Kwoh, MD, Professor of Medicine and Epidemiology, Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Center for Health Equity Research and Promotion, Veterans Administration Pittsburgh Health Care System; L.S. Crossett, MD, Assistant Professor, Department of Orthopaedic Surgery, University of Pittsburgh. Address reprint requests to Dr. D.L. Jones, Division of Rheumatology and Clinical Immunology, University of Pittsburgh, 3500 Terrace Street, S727 Biomedical Science Tower, Pittsburgh, PA 15261. E-mail: Dljst4@pitt.edu Submitted January 20, 2003; revision accepted January 23, 2004. |