Improving activities and satisfaction of younger osteoarthritis patients after knee arthroplasty and osteotomy: A patient tailored approach

The aims of this thesis were to investigate activities after knee arthroplasty (KA) and realignment osteotomies, younger knee OA patients’ expectations and activity goals, and to search for individualized ways to -realistically- improve satisfaction for activities of daily life, work and leisure time after KA. Conclusions: 1. Younger patients expect different activities to perform better after KA, that varied most in leisure time activities. 2. Return to both low- and higher-impact sports is possible after both Total KA (TKA) and Unicondylar KA (UKA), but seemed more likely after UKA than after TKA. 3. We found better outcomes for KA in anteromedial osteoarthritis (AMOA), compared to more advanced OA and other wear patterns, and this was slightly more likely if treated with UKA than with KA. 4. Patients can also return to sports activities and work after realignment osteotomies, also when they are young and athletic, and more likely than after KA. 5. Concerning ‘usual care’ rehabilitation after KA broad agreement amongst physiotherapists exists about goals for rehabilitation, but they use a variety of strategies to achieve those goals. 6. We described the intervention group of our ACTION trial, that followed rehabilitation using Goal Attainment Scaling (GAS) after KA. We showed that patients wished to achieve many activity goals, but that following six months of rehabilitation with GAS, almost all activity goals (91%) were attained; 7. Moreover, GAS-based rehabilitation after KA led to significant improvement of satisfaction for activities to Visual Analogue Scales of 80/100 at six months after surgery.