Muscle Strength and Total Knee Replacement

Knee Extensor Muscle Strength and Physical Function Before and After Total Knee Replacement

Purposes: To compare knee extensor muscle strength, physical function and self-reported function before and after total knee replacement with healthy age-matched controls. To describe changes in knee extensor muscle strength up to one year after surgery. To study the relationship between changes in knee extensor muscle strength and changes in physical function, self-reported function and physical activity level and the relationship between changes in knee extensor muscle strength and satisfaction.

Methods: A prospective observational study and comparison with controls. 50-55 individuals aged 65 or older, scheduled for total knee arthroplasty will be recruited to the study group. Measurement of study group 0-2 weeks before surgery and 3, 6 and 12 months following surgery. Comparison with 50-55 healthy age-matched controls.

Study Overview

• Status: Completed
• Conditions: Osteo Arthritis Knee; Arthropathy of Knee

• Study Type: Observational
• Enrollment (Actual): 57

Contacts and Locations

Study Locations

• Sweden
  • Alingsås, Sweden
    • Närhälsan Sörhaga Rehabmottagning
  • Herrljunga, Sweden
    • Närhälsan Herrljunga Rehabmottagning
  • Lerum, Sweden
    • Närhälsan Lerum Rehabmottagning

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Participants will be recruited from Alingsås Hospital which is located in the Västra Götaland Region of Sweden.

Description

Inclusion Criteria:

• Scheduled for total knee replacement on the basis of osteoarthritis of the knee
• Expected rehabilitation in a primary care setting

Exclusion Criteria:

• Difficulties reading or speaking Swedish
• Revision surgery
• Rehabilitation in other settings than primary care

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Study group; Patients scheduled for total knee replacement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in knee extensor muscle strength of the affected side from before surgery to one year after surgery	Maximum voluntary isometric contraction measured using the "make" method with hand-held dynamometry fixated in a knee extension strength training apparatus. Force measurement in Newtons.	Comparison of data before surgery (0-2 weeks) with data 3, 6 and 12 months after surgery
Comparison of knee extensor muscle strength of the affected side before surgery with controls	Maximum voluntary isometric contraction measured using the "make" method with hand-held dynamometry fixated in a knee extension strength training apparatus. Force measurement in Newtons.	Comparison of data before surgery (0-2 weeks) with data data from the control group
Comparison of knee extensor muscle strength of the affected side one year after surgery with controls	Maximum voluntary isometric contraction measured using the "make" method with hand-held dynamometry fixated in a knee extension strength training apparatus. Force measurement in Newtons.	Comparison of data one year after surgery with data data from the control group
Comparison of knee extensor muscle strength of the affected side with the unaffected side	Maximum voluntary isometric contraction measured using the "make" method with hand-held dynamometry fixated in a knee extension strength training apparatus. Force measurement in Newtons.	Before surgery (0-2 weeks). 3, 6 and 12 months after surgery.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comparison of 30 s chair stand test between study group and control group	30 s chair stand test measures the number of complete stands the test person is able to perform within 30 s.	Comparison of data for the study group from before surgery (0-2 weeks) and 12 months after surgery with data from the control group
Comparison of Knee injury and Osteoarthritis Outcome Score between study group and control group	Knee Injury and Osteoarthritis Outcome Score is a self-reported outcome questionnaire that measures 5 sub-scales: pain, other symptoms, function in daily living, function in sport and recreation and knee-related quality of life.	Comparison of data for the study group from before surgery (0-2 weeks) and 12 months after surgery with data from the control group
Comparison of 6-min walk test between study group and control group		Comparison of data for the study group from before surgery (0-2 weeks) and 12 months after surgery with data from the control group
Correlation between changes in knee extensor muscle strength of the affected side before and after surgery with changes in 30 s chair stand test, Knee injury and Osteoarthritis Outcome Score, 6-min walk test and physical activity level	Physical activity level will be measured as activity minutes using a questionnaire.	Before surgery (0-2 weeks) and 12 months after surgery
Correlation between changes in knee extensor muscle strength of the affected side before and after surgery with overall satisfaction one year after surgery	Satisfaction will be measured using a 4-point likert scale.	Changes in muscle strength from before surgery (0-2 weeks) and 12 months after surgery, satisfaction 12 months after surgery

Collaborators and Investigators

• Sponsor: Vastra Gotaland Region
• Investigators: Principal Investigator: Anette Larsson, PhD, Närhälsan Rehabilitering

Study record dates

Study Major Dates

• Study Start (Actual): November 12, 2021
• Primary Completion (Actual): December 1, 2023
• Study Completion (Actual): December 1, 2023

Study Registration Dates

• First Submitted: February 9, 2022
• First Submitted That Met QC Criteria: February 9, 2022
• First Posted (Actual): February 21, 2022

Study Record Updates

• Last Update Posted (Actual): May 25, 2025
• Last Update Submitted That Met QC Criteria: May 20, 2025
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Knee
• Other Study ID Numbers: Muscle strength and TKP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No