• Jack Crosbie, Justine Naylor, Alison Harmer, and Tyson Russell.
• School of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia. j.crosbie@usyd.edu.au
• Disabil Rehabil. 2010 Jan 1; 32 (13): 1088-98.

PurposeTo investigate whether measured and patient-perceived function 6 months after total knee replacement (TKR) can be predicted from factors measured during post-operative rehabilitation.MethodRetrospective analysis of data from a randomised clinical trial involving 100 patients after TKR. High- and low-performing subjects for pain, WOMAC score and 6-min walk test (6MWT) at 2, 8 and 26 weeks post-TKR were partitioned and analysed. Multiple stepwise regression analysis was applied to the contributing factors to determine associations with outcome.ResultsPrediction of outcome was unconvincing based upon variables recorded at 2 weeks; however, status at 8 weeks was a better indicator of functional performance and perception at 26 weeks. 6MWT at 26 weeks could be predicted from VAS pain scores and 6MWT at 8 weeks (r = 0.789; p < 0.001). Prediction of pain and patient perceived function at 26 weeks was also dependent on performance in 6MWT at 8 weeks (r = 0.51; p < 0.05). Males and those with lower body mass index values demonstrated better functional outcomes.ConclusionFunctional status at 2 weeks post-surgery gives few indicators of ultimate status, possibly because of pain, joint swelling and other immediate post-operative factors. However, measurements taken at 8 weeks, following an outpatient-based exercise programme, provides a reasonable estimate of performance and response 26 weeks after surgery. Patient and clinician expectations for longer-term recovery could be informed by these findings.

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