Original Article

Factors lead to return to sports and recreational activity after total knee replacement

A retrospective study

¹ FIFA Medical Center of Excellence, Department of Orthopaedic Surgery and Sports Medicine, Croix Rousse Hospital, Civil Hospices of Lyon, 69004 Lyon, France
² LBMC UMR T 9406, Laboratory of Chock Mechanics and Biomechanics, Claude Bernard Lyon 1 University, 69100 Villeurbanne, France
³ LIBM – EA 7424, Interuniversity Laboratory of Biology of Mobility, Claude Bernard Lyon 1 University, 69100 Villeurbanne, France
⁴ Department of Orthopedic and Traumatology, Dijon University Hospital, 21000 Dijon, France
⁵ Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122 Milan, Italy
⁶ Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy

^* Corresponding author: jeremyplassard@live.fr

Received: 13 April 2020
Accepted: 16 April 2020

Abstract

Introduction: The number of total knee replacements performed (TKR) is increasing and so are patient expectations and functional demands. The mean age at which orthopedic surgeons may indicate TKR is decreasing, and therefore return to sport (RTS) after TKR is often an important expectation for patients. The aim of this study was to analyze the mid-term RTS, recreational activities, satisfaction level, and forgotten joint level after TKR. Methods: Between January 2015 and December 2016, 536 TKR (same implant design, same technique) were performed in our center. The mean age at survey was 69 years with a mean follow-up of 43 months. All patients who did not have a follow-up in the last 6 months were called. Finally, 443 TKR were analyzed. RTS was assessed using the University of California Los Angeles Scale (UCLA), forgotten joint score (FJS), and Satisfaction Score. Results: In this study, 85% of patients had RTS after TKR with a mean UCLA score increasing from 4.48 to 5.92 and a high satisfaction rate. Satisfaction with activity level was 93% (satisfied and very satisfied patients). The RTS is more important for people with a higher preoperative UCLA score and a lower American Society of Anesthesiologist score (ASA). Each point increase in ASA score is associated with reduced probability to RTS by 52%. Discussion: RTS and recreational activity were likely after TKR with a high satisfaction score. Preoperative condition and activity are the two most significant predictive factors for RTS. Level of evidence: Retrospective case series, level IV.