Heterogeneity of social participation in patients three months after total knee arthroplasty: a latent profile analysis.

Social participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients' functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients. This cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants' data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients' social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups. Three months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05). These results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.

Qu W ，Yan Z ，Wei H ，Zhang S ，Wang X ，Liu M ，Wang J ，Luan X ... -  《BMC MUSCULOSKELETAL DISORDERS》

Heterogeneous trajectories of kinesiophobia and their effects on rehabilitation outcomes after total knee arthroplasty: a prospective cohort study.

Kinesiophobia is one of the most common and aversive psychological phenomena among patients after total knee arthroplasty (TKA). This study aimed to identify trajectories of kinesiophobia, examine factors distinguishing these trajectories, and clarify the association between trajectories of kinesiophobia and rehabilitation outcomes. In this prospective cohort study, the patients who underwent TKA were recruited between December 2021 and April 2022 from three orthopedic wards of a tertiary hospital in China. Kinesiophobia was measured using the Tampa Scale for Kinesiophobia at baseline (T0), and then at 1 month (T1) and 3 months (T2) after TKA to perform latent class growth analysis. Meanwhile, rehabilitation outcomes were assessed at 3 months after TKA, using the Kessler Psychological Distress Scale, the Hospital for Special Surgery-Knee Scale, Barthel Index, and the Impact on Participation and Autonomy questionnaire. The four kinesiophobia trajectories identified were as follows: low stable group (n = 120), rapid recovering group (n = 31), slow recovering group (n = 48), and stable moderate group (n = 58). Body mass index, employment status, heart disease, and pain degree significantly predicted trajectory groups (all p < 0.05). Analysis of variance revealed significant differences between the four kinesiophobia trajectories concerning all rehabilitation outcomes, except for the activities of daily living. Distinct kinesiophobia trajectories were identified, and nurses should assess the kinesiophobia of patients after TKA in the early phase. Patients in the slow recovering group are worthy of a specific focus because of their poor recovery after undergoing TKA. As important sources of psychosocial care, nurses need to customize psychological interventions for patients after TKA depending on each kinesiophobia trajectory.

Yan Z ，Wu Y ，Liu M ，Wang X ，Wang J ，Wang Z ，Wu S ，Luan X ... -  《Journal of Orthopaedic Surgery and Research》

Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty.

Doury-Panchout F ，Metivier JC ，Fouquet B 《-》

Assessing perceived participation among older adults total hip arthroplasty and total knee arthroplasty patients six months post-surgery: a cross-sectional study.

This research sought to assess the perceived levels of participation and autonomy in senior patients who had received total hip arthroplasty (THA) or total knee arthroplasty (TKA) in Hangzhou, China. Furthermore, the study aimed to identify the factors linked to these outcomes. This investigation will utilize a cross-sectional study design to assess perceived participation and autonomy among older adults total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. The research was conducted in Hangzhou, China, at a tertiary hospital. Convenient sampling was utilized to select 139 patients who underwent THA or TKA between March 2022 and March 2023 and met the inclusion criteria at a tertiary hospital in Hangzhou. The Impact on Participation and Autonomy Questionnaire, Hip/Knee Injury and Osteoarthritis Outcome Score (HOOS/KOOS), 5-Item Geriatric Depression Scale, Multidimensional Scale of Perceived Social Support, and Elders Health Empowerment Scale were used to assess perceived participation, hip/knee-related symptoms and functional restrictions, depression symptoms, social support, and health empowerment. The mean score for perceived participation and autonomy was 22.554 (SD: 13.042). The mean scores for participation in indoor autonomy, outdoor autonomy, family roles, and social relations were 0.654 (SD: 0.608), 1.324 (SD: 0.792), 1.053 (SD: 0.657), and 0.664 (SD: 0.542), respectively. Negative correlations were observed between perceived participation/autonomy scores and HOOS/KOOS, social support, and health empowerment scores. Conversely, a positive correlation was found between perceived participation/autonomy scores and depression scores. The detrimental effect of HOOS/KOOS, social support, and health empowerment scores on perceived participation and autonomy was notable, while the impact of depressive symptoms was comparatively minor. Older Chinese patients, at first six months post THA/TKA surgery, reported higher levels of perceived participation compared to individuals with other conditions, such as stroke patients. Functional limitations resulting from hip/knee-related symptoms, as well as social support and health empowerment, emerged as significant influencing factors for perceived participation and autonomy. This research enhances our comprehension of the elements influencing perceived participation among older adults individuals who have undergone THA/TKA procedures.

Yao L ，Jia Q ，Wu J ，Chai Y ，Gao C ，Wang Y ，Li K ，Lai M ... -  《Frontiers in Public Health》

Incidence and Risk Factors of Kinesiophobia After Total Knee Arthroplasty in Zhengzhou, China: A Cross-Sectional Study.

The incidence of and risk factors for kinesiophobia after total knee arthroplasty (TKA) have not been well characterized in the literature. Thus, the aim of this study was to investigate the incidence of postoperative kinesiophobia among patients undergoing TKA and to identify the associated risk factors. The simplified Chinese version of the Tampa Scale for Kinesiophobia, Knee Self-Efficacy Scale, Numerical Rating Scale, Simplified Coping Style Questionnaire, and Social Support Rating Scale were used to measure kinesiophobia, self-efficacy, pain intensity, coping styles and social support, respectively. Multivariate logistic regression analyses were utilized to identify the risk factors for postoperative kinesiophobia among TKAs. A total of 862 participants were included in this study. Among all participants, 210 (24.4%) were identified as having kinesiophobia according the Tampa Scale for Kinesiophobia (TSK>37), with a mean score of 32.5 (standard deviation 13.1). A multivariate regression analysis showed that older age (odds ratio [OR] = 2.8, confidence interval [CI] = 2.0-3.7), lower education level (OR = 1.7, CI = 1.3-2.4), negative coping styles (OR = 1.6, CI = 1.0-2.2), less social support (OR = 3.5, CI = 3.1-4.1), lower self-efficacy (OR = 1.4, CI = 1.1-1.7), and greater pain intensity (OR = 2.8, CI = 1.5-5.3) are independent risk factors for kinesiophobia. A 24.4% incidence rate of postoperative kinesiophobia was noted in patients following TKA. Older age (most notably ≥76 years old), lower education levels, negative coping styles, greater pain intensity, lower self-efficacy, and less social support were associated with odds of developing postoperative kinesiophobia.

Cai L ，Liu Y ，Xu H ，Xu Q ，Wang Y ，Lyu P ... -  《-》