Background/Purpose:

We previously identified several barriers and facilitators of exercise before total knee arthroplasty (TKA) in a small qualitative study, as well as the existence of patient-reported anxiety in anticipation of TKA. We aim to further explore these domains in a larger group of patients who had TKA within 6 months in order to understand specific patient needs in the design of a pre-habilitation program for TKA.

Methods:

We designed a cross-sectional survey deployed online with questions abstracted from the themes that emerged from our previous qualitative study. Patients were > 40 years old from a single center and had a primary TKA ≥ 6 months ago. We asked patients about barriers and facilitators to exercise before and after TKA, such as knee pain, knowledge about and motivation to exercise, time to devote to exercise, and peer support. We also examined the prevalence of anxiety in anticipation of TKA and coping mechanisms to alleviate that anxiety.

Results: 79 patients who met the inclusion criteria responded to the survey, age range 50 – 89. 30% had a primary TKA on both knees. 63% (N = 50) were women and 87% (N = 69) were White (Table 1). A majority of patients (56%) exercised in preparation for TKA, and 22% attended physical therapy. The most common barriers to exercise before TKA were pain (56%), lack of motivation (33%), lack of time (16%) and lack of knowledge (33%) on how to exercise. The main facilitators to exercise were presence of social support (44%) and scheduled physical therapy appointments (52%) (Figure 1). In the 48% of patients (N = 38) who reported anxiety before TKA, 95% sought reassurance from family/friends while 92% asked about the experiences of those who already had TKA (Table 2). Only 1 patient sought professional counseling for their anxiety.

Conclusion: Knee pain was the major barrier to exercise in preparation for surgery, while social support and physical therapy were the two major facilitators. Anxiety was common and interacting with family, friends or even another person who already had TKA were strategies used to alleviate anxiety in preparation for TKA. Similar leveraging of social support may motivate individuals to engage in physical activity in preparation for TKA.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-preparation-experience-for-total-knee-arthroplasty-of-patients-with-osteoarthritis-a-cross-sectional-survey/