FRI0532 Relationship between patient-reported outcomes and proprioceptive acuity in patients with total knee arthroplasty

Abstract

Background: Total knee arthroplasty (TKA) is offered to patients who have endstage knee osteoarthritis (OA) to reduce pain and improve functional performance. Pain and functional level in patients with TKA can be measured using selfreport questionnaires such as the Numeric Pain Rating Scale (NPRS), Hospital for Special Surgery (HSS), Iowa Level of Assistance Scale (ILAS), and Iowa Ambulation Velocity Scale (IAVS). Proprioception plays an integral role in neuromotor control of the knee joint and deficits in knee joint proprioception are well documented in individuals with knee osteoarthritis. However, the patient-reported functional level relevance of these deficits is not clear in both individuals with knee OA and with TKA. Objective(s): The aim of this study was to assess relationship between pre-/postsurgery patient-reported outcomes and proprioceptive acuity in patient with TKA due to knee OA. Method(s): The study group consisted of 68 patients (12 males, 56 females), who underwent primary TKR because of knee arthrosis were included in the study with mean age 64.9+/-9.1 years. Patients were evaluated regarding the knee proprioception (in knee joint angle 15E, 30E), pain (NPRS), HSS knee function score. Functional activities were evaluated using the ILAS and walking speed was evaluated using the IAVS. Patients were evaluated preoperatively and at discharge. All patients underwent the same rehabilitation program. Result(s): While there were correlations in different rates in individuals with knee OA between patient-reported outcomes and proprioceptive acuity, there were no correlations in individuals with TKA between patient-reported outcomes and proprioceptive acuity. Preoperatively, low-to-moderate significant correlations was found between pain and proprioceptive acuity deficit scores in knee joint angle 15E, 30E (r=-0.196, p=0.046 and r=-0.378, p<0.001, respectively). There were low significant correlations preoperatively between HSS knee score and proprioceptive acuity deficit scores in knee joint angle 15E, 30E (r=0.217, p=0.027, and r=0.275, p=0.005, respectively). There were not significant correlations between proprioceptive acuity deficit scores and all other evaluation tests (p>0.05). Conclusion(s): There were correlations in different rates in patients with knee OA between patient-reported outcomes and proprioceptive acuity, however there were no correlations in patients with TKA between patient-reported outcomes and proprioceptive acuity. These results suggest that patients who have knee OA and with poor proprioception show more limitation in functional ability and have more pain level. On the other hand, deficits in joint position sense in patients with TKA may be due to factors other than pain and functional disability. Poor proprioception in patients with TKA may be due to surgery related resection of articular cartilage, meniscuses, articular ligaments.