Return to Work after Primary Total Knee Arthroplasty: The First Polish Pilot Retrospective Study.

(1) Background: Total knee arthroplasty (TKA) performed on working-age patients significantly affects the participation of such patients in social life. A retrospective study was conducted to determine the return to work (RTW) rate after TKA. The goal of this study was to provide reference data for the Polish population and identify the factors impacting patients' decisions to return to or resign from work, relative to their functional performance. (2) Methods: This retrospective study involved 48 patients. An interview related to RTW was carried out to identify the factors impacting a patient's decision to return to or resign from work. Functional performance was assessed using the Knee Outcome Survey-Activities of Daily Living (KOS-ADL) scale. (3) Results: Before TKA, 15 individuals (31.25%) qualified for the study did not work and were receiving welfare benefits. After the surgery, 23 individuals (47.9% of those working prior to TKA) did not return to work. The number of those who did not work after TKA increased to 38 (79.17%), which was a significant change. The mean level of functional performance after TKA assessed using KOS-ADL was 75.89. (4) Conclusions: The findings show that the rate of RTW after TKA in Poland is significantly lower than that in other countries. The reasons for this situation, as shown in the study, may be related to the lack of an occupational rehabilitation system, resulting in a paucity of information about the possibility to return to work and about opportunities for retraining.

The Influence of Implant Position on Final Clinical Outcome and Gait Analysis after Total Knee Arthroplasty.

The aim of the study was to evaluate the impact of implant component alignment on objective and subjective outcomes after total knee arthroplasty (TKA). The rotation of the femoral component and its influence on the final results were also examined. After exclusion, the study examined 102 patients (mean age, 66.28 years; range, 51-79 years) who had undergone unilateral TKA. All of the operative procedures were performed by one surgeon with one type of implant. One year after the operation, improvements in Knee Society's Knee Scoring System, functional score, Western Ontario and McMaster Universities Osteoarthritis Index, and Visual Analog Scale were observed; however, none showed a significant correlation with any of the parameters analyzed by X-ray or computed tomography (CT) (α, ß, γ, δ angles and posterior condylar angle [PCA]). Significant improvements were found for the vast majority of the parameters used for gate analysis at the final follow-up. Significant correlations were found between PCA angle and differences in stance phase, swing phase of the operated limb, and step width (all p = 0.03). No other significant relationships were found between gait parameters and indicators measured by X-ray and CT. None of the analyzed radiographic parameters, including rotation of the femoral component, correlated with final clinical results. Neither femoral internal rotation of 3° to 6°, nor rotation of 0° ± 3° or 0° ± 6° influenced the outcome. One year after TKA, a significant improvement was observed in both functional and gait parameters.

Polish Cross-Cultural Adaptation and Validation of the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) in Patients Undergoing Total Knee Arthroplasty.

BACKGROUND The Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) is a self-reported questionnaire used for the evaluation of the overall health of patients with knee dysfunctions. The purpose of this study was to perform a cross-cultural adaptation of the Polish version of KOS-ADLS and to evaluate its psychometric properties in patients at the end-stage of knee osteoarthritis who were qualified for a total knee replacement (TKR). MATERIAL AND METHODS Seventy patients consecutively qualified for surgical TKR procedure participated in this study. To adapt the KOS-ADLS, the following scales and reference tests were used: Knee injury and Osteoarthritis Outcome Score (KOOS), Visual Analogue Scale (VAS), Time Up and Go test (TUG), and Five Times Sit to Stand test (5×STS). The studies were conducted 3 times: 2 weeks before surgery (first study), 6 to 13 days later (retest), and 6 months after surgery. RESULTS The Polish version of KOS-ADLS showed excellent reliability (ICC=0.89 SEM=2.68, MDC=7.43) and high responsiveness (ES=4.76, SRM=3.18). The internal consistency was poor in the first assessment (Cronbach's alpha=0.68), but acceptable in the post-surgery evaluation (Cronbach's alpha=0.86). There were fair and moderate correlations found between KOS-ADLS and VAS scales in the first examination, TUG, and 5×STS. Stronger correlations were observed between the results obtained in KOS-ADLS and KOOS. CONCLUSIONS The Polish version of the KOS-ADLS demonstrated good reliability, validity, and responsiveness for use in patients who have undergone TKR surgery.

Reconstruction of chronic patellar tendon rupture with semitendinosus tendon: case report.

Chronic patellar tendon rupture is a rare injury whose treatment poses technical difficulties. Surgical repair is mandatory to restore the extensor mechanism of the knee. Many different surgical methods of patellar tendon reconstruction have been described. We present the case of a 48-year-old male patient who sustained patellar tendon rupture 8 months before surgery. A semitendinosus tendon graft and the modified Ecker technique were used for the reconstruction of the patellar tendon. Full extension was achieved alongside high patient satisfaction. However, the patient required prolonged intensive rehabilitation.