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In active individuals, a change in preoperative activity can result in improvement in outcomes. Preoperative functional activity was associated with long-term outcomes after TKR. The study was limited by its short-term follow-up. Passive individuals were more likely to have a clinically meaningful improvement (OR 1.7 ). Active individuals were approximately twice as likely to report worse function and pain (OR 2.2 ) and 1.5 times more likely to report no improvement (OR 1.5 ). At 48 months, approximately 50% of active individuals had a clinically meaningful improvement in pain and function.
At 48 months, there was a statistically significant difference between active and passive individuals with regards to KOOS and WOMAC scores. Active individuals had more preoperative pain and functional limitation than passive individuals. Functional activity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee injury and Osteoarthritis Outcome Score (KOOS). Activities of daily living and knee-related health-related quality-of-life scales were administered preoperatively and at 2, 4, 12, 24 and 48 months postoperatively. Patients were enrolled in a long-term prospective study at the National Health Service Orthopaedic Centre at Christchurch Hospital in Christchurch, New Zealand. To study the effect of preoperative functional activity on clinical outcome in patients who underwent primary total knee replacement (TKR).
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