Authors (including presenting author) :
Choi JMC(2), Luk Michelle Hilda (1), Chan VWK (4), Ng TYL (2)(3), Leung TKC (1), Lau LCM (5), Cheung A (1), Chan PK(5), Chiu KY(5), Fu H (1)
Affiliation :
(1) Department of Orthopaedics and Traumatology, Queen Mary Hospital
(2) Occupational Therapy Department, Duchess of Kent Children’s Hospital
(3) Occupational Therapy Department, MacLehose Medical Rehab Center
(4) Department of Orthopaedics and Traumatology, Rotorua Hospital, New Zealand
(5) Department of Orthopaedics and Traumatology, The University of Hong Kong
Introduction :
HKWC adopts fast-track recovery protocols, where patients have a short length of stay and are expected to continue their functional rehabilitation within the community. In view of the shortened hospital length of stay, patient should be better managed for their expectation on functional recovery after TKA. The objective of this study is to evaluate the recovery progress of patient after TKA. We would like to have the normative information about the outcomes of TKA and the recovery pattern. In addition to the conventional functioning score outcomes and subjective questionnaire, we adopted the wearable device to monitor the rehabilitation progress of patients with TKA.
Objectives :
The objective of this study is to evaluate the recovery progress of patient after TKA. We would like to have the normative information about the outcomes of TKA and the recovery pattern. In addition to the conventional functioning score outcomes and subjective questionnaire, we adopted the wearable device to monitor the rehabilitation progress of patients with TKA.
Methodology :
The prospective study included patients who underwent TKA between Oct 2022 and April 2024 at DKCH. Functional rehab program was offered to all patients on in-patient and out-patient basis. Assessment was conducted at pre-op, post-op 6 weeks and 3 months. Patients were assessed on their ADL by Motor scores of Functional Independence Measures (mFIM), Instrumental ADL scores by Lawton’s IADL. All participants required wore commercial wearable device for 10 days consecutively at corresponding time points. Data collected were daily steps and daily minutes engaged in moderate to heavy physical activities (MHA).
Result & Outcome :
A drop of ADL at post-op 6 weeks but the gain was drastic at the period from 6 weeks, ADL performance at 3 months was significantly higher than the pre-operative scores (1.25 95% CI 0.14 to 2.36 p<0.05). Improvement in IADL when compared to pre-op with post-op 3-month (1.59 (95%CI, 0.11 to 3.07, p<0.05)
Statistically significant decrease in average daily steps at pre-op compared to 6 weeks (-2531 95%
-3974 to -1087 to, p<0.05), but no significant difference from pre-op to 3 months (68.1 95% CI -1226 to 1363 P=1.000), that indicated the resumption of daily steps counts happened at post-op 3 months but may not at 6 weeks.
Moderate drop to MHA minutes at post-op 6 weeks compared pre-op level but the change is not statistically significant (-11.02 CI 95% -22.87 to 0.82, p>0.05). There was significant increase of MHA minutes from post-op 6 weeks to 3 months (7.5 95% CI, 1.58 to 13.42, p< 0.05). The MHA minutes has no significant difference compared to pre-op and 3 months post-op (3.5 95% CI -8.17 to 15.23 p=1). The resumption of activity minutes was returned to premorbid at 3 months.
ADL and IADL performance were significantly improved at post-op 3-month compared with pre-operative level. The finding on average daily steps and MHA minutes returned to premorbid at 3-month post-op. The findings were differed from prior studies that total daily steps recovered to preoperative levels at 6 weeks post-operatively. With reference to this finding, it is suggested that the OP OT follow-up can be modified to post-op day 7, 3 weeks, 8 weeks and 3 months so that OT could monitor recovery and provide prompt intervention to both IADL and physical activities resumption.
