Knee Osteoarthritis
Conditions
Keywords
total knee arthroplasty, phase angle, sarcopenia, bioelectrical impedance
Brief summary
The goal of this observational study is to compare the functional outcome of patients with end-stage knee osteoarthritis (OA) before and after total knee arthroplasty based on the phase angle level. The main questions it aims to answer are: * Do patients with low phase angle show worse functional recovery after total knee arthroplasty compared to those with high phase angle? * Is postoperative physical function associated with preoperative phase angle level? Researchers will compare postoperative physical function and muscle strength between the low and high phase angle groups to determine whether a low phase angle is associated with poorer functional recovery. Participants will: Perform physical function tests, isokinetic strength assessments, and bioelectrical impedance analysis before and three months after surgery.
Detailed description
After obtaining informed consent, a pre-surgical screening is conducted. Participants complete a history survey, a sarcopenia questionnaire, and the International Physical Activity Questionnaire (IPAQ). The screening includes a comprehensive evaluation of baseline symptoms, followed by functional assessments that incorporate bioelectrical impedance analysis, muscle strength testing, and performance-based tests: * A modified Charlson Comorbidity Index (CCI) is used to assess comorbidity burden, and a Numeric Pain Rating Scale (NPRS) records participants' initial pain levels. * Radiographic assessments are performed to evaluate the frontal alignment of the lower extremities and the radiographic severity of knee osteoarthritis (OA) using the Kellgren-Lawrence (K-L) grading system. * Multifrequency bioelectrical impedance analysis (BIA) is used to measure phase angle and body composition. * Handgrip strength is measured through three trials on each side, with the average recorded. * Knee strength is measured using an isokinetic dynamometer. * Performance-based tests include the 10-meter walk test, the Timed Up and Go (TUG) test, and the Berg Balance Scale (BBS). Follow-up assessments are conducted three months after total knee arthroplasty, with participants undergoing the same protocol for performance-based tests, isokinetic knee strength evaluation, and bioelectrical impedance analysis.
Interventions
None listed
Sponsors
Yonsei University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
55 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Individuals aged 55 and over (based on the age on their national ID at the time of consent) * Individuals diagnosed with knee OA based on medical history, physical examination, and radiographic assessments. * Individuals who plan to perform total knee arthroplasty
Exclusion criteria
* Individuals with gait disturbance due to neurologic disorders such as Parkinson disease, stroke and dementia * Individuals with severe cardiac, pulmonary, or musculoskeletal disorders that limited quadriceps strength and physical function * Individuals with knee osteoarthritis due to secondary causes such as rheumatic or traumatic arthritis * Individuals with a history of any knee surgery within one year. * Individuals considered clinically unsuitable for the study by the researchers or person in charge based on significant medical findings.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Timed up and go test (TUG) | Baseline and 3 months after surgery | Researchers ask patients to rise from a seated position, walk a distance of 3 m, turn around, return to the chair, and sit back. The average time of three trials was recorded as a result |
| 10 meter walk test (10MWT) | Baseline and 3 months after surgery | Patients are instructed to walk 14 m, including 2 m at both ends for acceleration and deceleration, at their comfortable speed. Gait speed was calculated by dividing the 10m distance by the time taken. |
| Berg balance scale (BBS) | Baseline and 3 months after surgery | Patients are asked to perform 14 tasks regarding the static and dynamic balance of patients. Each task was rated on a five-point scale from 0 to 4, with a total score of 56. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Isokinetic peak torque of knee extension at 150°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the peak extension torque is performed at preset constant angular velocities, 150°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
| Isokinetic total work of knee flexion at 60°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the total knee flexion effort is performed at preset constant angular velocities, 60°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
| Isokinetic total work of knee flexion at 150°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the total knee flexion effort is performed at preset constant angular velocities, 150°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
| Isokinetic peak torque of knee flexion at 60°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the peak flexion torque is performed at preset constant angular velocities, 60°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
| Isokinetic total work of knee extension at 150°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the total knee extension effort is performed at preset constant angular velocities, 150°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
| Whole body phase angle at 50kHz | Baseline and 3 months after surgery | * Whole body phase angle is calculated using the multifrequency Bioelectrical impedance analysis (BIA) with the InBody S10 (BioSpace, Seoul, Korea). * Before measurement, all patients are asked to fast for a minimum of 3 hours with the bladder emptied and avoid alcohol or vigorous activity. * Tetrapolar 8-point electrodes are placed on the dorsal surfaces of both wrist and foot according to the manufacturer's instruction. * After resting for 15 minutes, a weak current under 100uA is applied to measure the reactance (Xc) and impedance (R) of 6 Different Frequencies (1kHz, 5kHz, 50kHz, 250kHz, 500kHz, 1000kHz). * A whole body Phase angle is calculated as an arctangent of the Xc to R ratio at 50kHz. \[Phase angle (degrees) arctan(Xc/R) (180/π)\] |
| Isokinetic total work of knee extension at 60°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the total knee extension effort is performed at preset constant angular velocities, 60°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
| Isokinetic peak torque of knee flexion at 150°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the peak flexion torque is performed at preset constant angular velocities, 150°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
| Isokinetic peak torque of knee extension at 60°/s | Baseline and 3 months after surgery | * Isokinetic knee assessment is assessed using an isokinetic dynamometer (Cybex NORM®, Humac, CA, USA). * Each participant is positioned on an adjustable chair and secured to the equipment with straps across the trunk, hip, and thigh. * Gravity correction measurements are made according to the manufacturer's instructions. * Participants are instructed on standardized procedures before and during the test. * Concentric measurement of the peak extension torque is performed at preset constant angular velocities, 60°/s, with a rest period between each trial to prevent fatigue and ensure consistent effort levels. * Participants warm up with five to six submaximal practice repetitions before each test series. After repeating three times, the examiner records the average value. |
Countries
South Korea
Contacts
Primary ContactNa Young Kim, MD, PhD
Backup ContactYoung Seok Kim, MD
Outcome results
None listed